Provider Demographics
NPI:1134959851
Name:HUBER, CHERYL (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:HUBER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10920 JOHN CUSSONS DR
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-2036
Mailing Address - Country:US
Mailing Address - Phone:434-713-9090
Mailing Address - Fax:
Practice Address - Street 1:2101 E PARHAM RD STE 102
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-2234
Practice Address - Country:US
Practice Address - Phone:804-799-9292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA00241908942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry