Provider Demographics
NPI:1821694811
Name:PHILLIPS, CHERYL
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 HIGHGATE DR STE 213
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6622
Mailing Address - Country:US
Mailing Address - Phone:919-493-1975
Mailing Address - Fax:919-400-4492
Practice Address - Street 1:5317 HIGHGATE DR STE 213
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6622
Practice Address - Country:US
Practice Address - Phone:919-493-1975
Practice Address - Fax:919-400-4492
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health