Provider Demographics
NPI:1790991578
Name:CHERRY, KIMBERLY LAHM (LMFT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LAHM
Last Name:CHERRY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 LOVEDALE LN
Mailing Address - Street 2:APT. H
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-2362
Mailing Address - Country:US
Mailing Address - Phone:202-685-0992
Mailing Address - Fax:202-433-0654
Practice Address - Street 1:2767 WATSON RD SW
Practice Address - Street 2:BUILDING 72 SUITE 101
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20373-0001
Practice Address - Country:US
Practice Address - Phone:202-685-0992
Practice Address - Fax:202-433-0654
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000460106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist