Provider Demographics
NPI:1376612655
Name:LYFORD, CHERYL (LMHC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:LYFORD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-0158
Mailing Address - Country:US
Mailing Address - Phone:508-790-0577
Mailing Address - Fax:508-593-3326
Practice Address - Street 1:923 ROUTE 6A
Practice Address - Street 2:SUITE T
Practice Address - City:YARMOUTH PORT
Practice Address - State:MA
Practice Address - Zip Code:02675-2159
Practice Address - Country:US
Practice Address - Phone:508-790-0577
Practice Address - Fax:508-593-3326
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5359101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health