Provider Demographics
NPI:1730288630
Name:TROUT, CHERYLLE LYNNE (MSSW CSW)
Entity Type:Individual
Prefix:MRS
First Name:CHERYLLE
Middle Name:LYNNE
Last Name:TROUT
Suffix:
Gender:F
Credentials:MSSW CSW
Other - Prefix:
Other - First Name:CHERYLLE
Other - Middle Name:LYNNE
Other - Last Name:COLUMBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1765 KINGS CHURCH ROAD
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40071
Mailing Address - Country:US
Mailing Address - Phone:502-538-0782
Mailing Address - Fax:
Practice Address - Street 1:800 ZORN AVENUE
Practice Address - Street 2:VAMC
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206
Practice Address - Country:US
Practice Address - Phone:502-287-4000
Practice Address - Fax:502-287-6197
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY4853104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker