Provider Demographics
NPI:1679687990
Name:FROMMELT, CHERYL ANN (MS, LCPC, LMFT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:FROMMELT
Suffix:
Gender:F
Credentials:MS, LCPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 RAYMOND DR STE 305
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-9792
Mailing Address - Country:US
Mailing Address - Phone:630-718-0717
Mailing Address - Fax:630-718-0747
Practice Address - Street 1:640 N RIVER RD STE 108
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8947
Practice Address - Country:US
Practice Address - Phone:630-718-0717
Practice Address - Fax:630-718-0747
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166000555106H00000X
IL180001004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0002225381OtherBLUE CROSS BLUE SHIELD