Provider Demographics
NPI:1336740836
Name:LEE, CHERHEA (CDCA)
Entity Type:Individual
Prefix:MRS
First Name:CHERHEA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6810 SHOOTERS HILL RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1230
Mailing Address - Country:US
Mailing Address - Phone:419-262-9697
Mailing Address - Fax:
Practice Address - Street 1:3 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8603
Practice Address - Country:US
Practice Address - Phone:740-779-6612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH174682101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)