Provider Demographics
NPI:1942759519
Name:CHERRY, KATRINA (LCPC)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:CHERRY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 2ND ST W # 400
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-3001
Mailing Address - Country:US
Mailing Address - Phone:406-219-8334
Mailing Address - Fax:
Practice Address - Street 1:664 NORTHWOODS DR
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-8109
Practice Address - Country:US
Practice Address - Phone:406-570-8575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT19048101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health