Provider Demographics
NPI:1467163915
Name:MAY, CHERYL LYN (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LYN
Last Name:MAY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4204 FIRESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002-5840
Mailing Address - Country:US
Mailing Address - Phone:269-350-1836
Mailing Address - Fax:
Practice Address - Street 1:GULL ROAD JUSTICE COMPLEX
Practice Address - Street 2:1536 GULL RD
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048
Practice Address - Country:US
Practice Address - Phone:269-350-1836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017375101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional