Provider Demographics
NPI:1124274832
Name:STEPHENSON, CHER M (LMHC, CRC)
Entity type:Individual
Prefix:MRS
First Name:CHER
Middle Name:M
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:LMHC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4403 1ST AVE SE
Mailing Address - Street 2:SUITE 518
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3200
Mailing Address - Country:US
Mailing Address - Phone:319-396-4881
Mailing Address - Fax:319-396-4882
Practice Address - Street 1:4403 1ST AVE SE
Practice Address - Street 2:SUITE 518
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3200
Practice Address - Country:US
Practice Address - Phone:319-396-4881
Practice Address - Fax:319-396-4882
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IALMHC 00469101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health