Provider Demographics
NPI:1851408306
Name:CHASE, CHERYL ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL ANN
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7758 OAKHURST CIR
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1122
Mailing Address - Country:US
Mailing Address - Phone:216-401-6061
Mailing Address - Fax:
Practice Address - Street 1:6100 OAK TREE BLVD
Practice Address - Street 2:STE 200
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2544
Practice Address - Country:US
Practice Address - Phone:216-328-2045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2012-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6275103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical