Provider Demographics
NPI:1154372134
Name:EDWARDS, CHERYL LEE (MS, LPC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:LEE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4951 OLD GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-6906
Mailing Address - Country:US
Mailing Address - Phone:479-709-9880
Mailing Address - Fax:479-709-9887
Practice Address - Street 1:4951 OLD GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-6906
Practice Address - Country:US
Practice Address - Phone:479-709-9880
Practice Address - Fax:479-709-9887
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0311044101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health