Provider Demographics
NPI:1245451269
Name:SUBER, CHERYL LAVERNE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LAVERNE
Last Name:SUBER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 BROOKSDALE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-8415
Mailing Address - Country:US
Mailing Address - Phone:803-446-3830
Mailing Address - Fax:
Practice Address - Street 1:115 ATRIUM WAY STE 221
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6383
Practice Address - Country:US
Practice Address - Phone:843-501-1099
Practice Address - Fax:803-699-8824
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3188363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily