Provider Demographics
NPI:1598714453
Name:FLAKE, CHERI AUGUSTINE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:AUGUSTINE
Last Name:FLAKE
Suffix:
Gender:F
Credentials:LCSW
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 265
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30031-0265
Mailing Address - Country:US
Mailing Address - Phone:404-275-8352
Mailing Address - Fax:404-636-0080
Practice Address - Street 1:1790 CENTURY BLVD NE
Practice Address - Street 2:SUITE A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3322
Practice Address - Country:US
Practice Address - Phone:404-275-8352
Practice Address - Fax:404-636-0080
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW 32861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical