Provider Demographics
NPI:1124026596
Name:CHERICH, CAROL JEAN (LPC-LADAC)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:JEAN
Last Name:CHERICH
Suffix:
Gender:F
Credentials:LPC-LADAC
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:JEAN
Other - Last Name:CHERICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:7009 HEARTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PRINCE GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:23875-2664
Mailing Address - Country:US
Mailing Address - Phone:301-956-3185
Mailing Address - Fax:
Practice Address - Street 1:7009 HEARTHSIDE DR
Practice Address - Street 2:
Practice Address - City:PRINCE GEORGE
Practice Address - State:VA
Practice Address - Zip Code:23875-2664
Practice Address - Country:US
Practice Address - Phone:301-956-3185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2025-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101181101YP2500X
VA0089181101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1124026596Medicaid