Provider Demographics
NPI:1710535497
Name:MADISON, CHEREE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHEREE
Middle Name:
Last Name:MADISON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CHEREE
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:600 PEACHTREE PKWY STE 111
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6899
Mailing Address - Country:US
Mailing Address - Phone:678-804-9455
Mailing Address - Fax:
Practice Address - Street 1:600 PEACHTREE PKWY STE 111
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6899
Practice Address - Country:US
Practice Address - Phone:678-804-9455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010730101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional