Provider Demographics
NPI:1356518153
Name:CHERITH COUNSELING CENTER PC
Entity type:Organization
Organization Name:CHERITH COUNSELING CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FESTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-779-0478
Mailing Address - Street 1:215 E HUGHITT ST
Mailing Address - Street 2:P O BOX 1045
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-2957
Mailing Address - Country:US
Mailing Address - Phone:906-779-0478
Mailing Address - Fax:906-779-0479
Practice Address - Street 1:215 EAST HUGHITT STREET
Practice Address - Street 2:
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801
Practice Address - Country:US
Practice Address - Phone:906-779-0478
Practice Address - Fax:906-779-0479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health