Provider Demographics
NPI:1568804532
Name:HEMSOTH, CHERYL (LMHC NCC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:HEMSOTH
Suffix:
Gender:F
Credentials:LMHC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46703-0098
Mailing Address - Country:US
Mailing Address - Phone:260-668-8797
Mailing Address - Fax:260-665-1620
Practice Address - Street 1:603 N WAYNE ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-1081
Practice Address - Country:US
Practice Address - Phone:260-668-8797
Practice Address - Fax:260-665-1620
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001337A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health