Provider Demographics
NPI:1932148483
Name:KERR, CHERYL JEAN (PCC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:JEAN
Last Name:KERR
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3982 POWELL RD
Mailing Address - Street 2:S-173
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7662
Mailing Address - Country:US
Mailing Address - Phone:614-563-8572
Mailing Address - Fax:
Practice Address - Street 1:3962 N HAMPTON DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-8430
Practice Address - Country:US
Practice Address - Phone:614-563-8572
Practice Address - Fax:614-375-4959
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE4112101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor