Provider Demographics
NPI:1750786794
Name:O'CONNELL, CHERYL A (LPC, CPCS, BC-TMH)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:LPC, CPCS, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 ORCHARD RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-6977
Mailing Address - Country:US
Mailing Address - Phone:404-919-7334
Mailing Address - Fax:
Practice Address - Street 1:4605 ORCHARD RIDGE CT
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30028-6977
Practice Address - Country:US
Practice Address - Phone:404-919-7334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008091101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional