Provider Demographics
NPI:1316639503
Name:BRANNON, CHERISH (CAC, MAC)
Entity type:Individual
Prefix:
First Name:CHERISH
Middle Name:
Last Name:BRANNON
Suffix:
Gender:F
Credentials:CAC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 SARALAND BLVD N
Mailing Address - Street 2:
Mailing Address - City:SARALAND
Mailing Address - State:AL
Mailing Address - Zip Code:36571-2110
Mailing Address - Country:US
Mailing Address - Phone:251-320-3363
Mailing Address - Fax:
Practice Address - Street 1:360 SARALAND BLVD N
Practice Address - Street 2:
Practice Address - City:SARALAND
Practice Address - State:AL
Practice Address - Zip Code:36571-2110
Practice Address - Country:US
Practice Address - Phone:251-320-3363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)