Provider Demographics
NPI:1194345553
Name:SMITH, CHERRICE LACHALL (LPC)
Entity type:Individual
Prefix:
First Name:CHERRICE
Middle Name:LACHALL
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1669 ELYSE SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-4406
Mailing Address - Country:US
Mailing Address - Phone:678-308-7817
Mailing Address - Fax:
Practice Address - Street 1:1669 ELYSE SPRINGS DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-4406
Practice Address - Country:US
Practice Address - Phone:678-308-7817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-25
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007788101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional