Provider Demographics
NPI:1245095322
Name:BAYLOR, CHERELLE DENISE (LPC)
Entity type:Individual
Prefix:
First Name:CHERELLE
Middle Name:DENISE
Last Name:BAYLOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 VICTORIA BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23661-3031
Mailing Address - Country:US
Mailing Address - Phone:804-523-0744
Mailing Address - Fax:
Practice Address - Street 1:751 THIMBLE SHOALS BLVD STE K
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3563
Practice Address - Country:US
Practice Address - Phone:757-586-5350
Practice Address - Fax:757-586-5351
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013325101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional