Provider Demographics
NPI:1457634313
Name:TIMMONS, CHERI MICHELLE (LCSW, CEAP)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:MICHELLE
Last Name:TIMMONS
Suffix:
Gender:F
Credentials:LCSW, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-4206
Mailing Address - Country:US
Mailing Address - Phone:301-461-4052
Mailing Address - Fax:
Practice Address - Street 1:725 W MAIN ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NC
Practice Address - Zip Code:27282-7506
Practice Address - Country:US
Practice Address - Phone:301-461-4052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0073921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical