Provider Demographics
NPI:1881630317
Name:DESVERNINE, CHERYL NORTH (LPC, MAC, SAP)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:NORTH
Last Name:DESVERNINE
Suffix:
Gender:F
Credentials:LPC, MAC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9327 RAVENSWORTH CT
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-8708
Mailing Address - Country:US
Mailing Address - Phone:804-357-2486
Mailing Address - Fax:
Practice Address - Street 1:9327 RAVENSWORTH CT
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-8708
Practice Address - Country:US
Practice Address - Phone:804-357-2486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002731101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional