Provider Demographics
NPI:1255780334
Name:BARKER, CHERYL (PHD)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 WOODLAWN CIR
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-1231
Mailing Address - Country:US
Mailing Address - Phone:216-789-5074
Mailing Address - Fax:
Practice Address - Street 1:435 WOODLAWN CIR
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-1231
Practice Address - Country:US
Practice Address - Phone:216-789-5074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
OH1840103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No374U00000XNursing Service Related ProvidersHome Health Aide