Provider Demographics
NPI:1508865502
Name:LAWSON, CHERYL PHILLIPS (MA, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:PHILLIPS
Last Name:LAWSON
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1343 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5768
Mailing Address - Country:US
Mailing Address - Phone:336-221-8813
Mailing Address - Fax:
Practice Address - Street 1:1343 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5768
Practice Address - Country:US
Practice Address - Phone:336-221-8813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4196101YM0800X, 101YP2500X
SC8120101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC138T8OtherBCBSNC
NCB0938OtherMEDCOST PROVIDER ID
NC6102229Medicaid