Provider Demographics
NPI:1508235037
Name:HERRON, CHARI N (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:CHARI
Middle Name:N
Last Name:HERRON
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 1:3315 MEMORIAL PKWY SW STE B
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5316
Mailing Address - Country:US
Mailing Address - Phone:256-203-6360
Mailing Address - Fax:
Practice Address - Street 1:3315 MEMORIAL PKWY SW STE B
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5316
Practice Address - Country:US
Practice Address - Phone:256-203-6360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3932101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL330000014Medicaid