Provider Demographics
NPI:1942537766
Name:CHERRY, LYNDSEY EM (MA, PLPC)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:EM
Last Name:CHERRY
Suffix:
Gender:F
Credentials:MA, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 W CRESTVIEW ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-3311
Mailing Address - Country:US
Mailing Address - Phone:417-827-6452
Mailing Address - Fax:
Practice Address - Street 1:4811 W TARKIO ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-6727
Practice Address - Country:US
Practice Address - Phone:417-827-6452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008011066101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor