Provider Demographics
NPI:1437932209
Name:MOOREHEAD, CHERYL HICKS (LMFT-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:HICKS
Last Name:MOOREHEAD
Suffix:
Gender:F
Credentials:LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2631 GATTIS SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-2821
Mailing Address - Country:US
Mailing Address - Phone:254-466-3661
Mailing Address - Fax:
Practice Address - Street 1:2631 GATTIS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2821
Practice Address - Country:US
Practice Address - Phone:229-444-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204338106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist