Provider Demographics
NPI:1831673102
Name:HALL, CHERYL (LCMFT, LCAC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LCMFT, LCAC
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:WELCH, SANTEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1204 SE LOUIS DR
Mailing Address - Street 2:
Mailing Address - City:MULVANE
Mailing Address - State:KS
Mailing Address - Zip Code:67110-1139
Mailing Address - Country:US
Mailing Address - Phone:316-409-7857
Mailing Address - Fax:
Practice Address - Street 1:1204 SE LOUIS DR
Practice Address - Street 2:
Practice Address - City:MULVANE
Practice Address - State:KS
Practice Address - Zip Code:67110
Practice Address - Country:US
Practice Address - Phone:316-409-7857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS00864101YA0400X
KS03247106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)