Provider Demographics
NPI:1851615819
Name:HORD, CHERYL ANNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ANNE
Last Name:HORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1671
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:TX
Mailing Address - Zip Code:78055-1671
Mailing Address - Country:US
Mailing Address - Phone:830-460-1227
Mailing Address - Fax:
Practice Address - Street 1:867 ANTELOPE RUN
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:TX
Practice Address - Zip Code:78055-1671
Practice Address - Country:US
Practice Address - Phone:830-460-1227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17319101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional