Provider Demographics
NPI:1417439811
Name:BARHAM, CHERI J (CAC II)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:J
Last Name:BARHAM
Suffix:
Gender:F
Credentials:CAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 E PLATTE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5738
Mailing Address - Country:US
Mailing Address - Phone:719-358-6559
Mailing Address - Fax:719-418-3728
Practice Address - Street 1:1826 E PLATTE AVE STE 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5738
Practice Address - Country:US
Practice Address - Phone:719-358-6559
Practice Address - Fax:719-418-3728
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB.0008320101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)