Provider Demographics
NPI:1588355374
Name:CARTER, CHERYL
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 COUNTY ROAD 51
Mailing Address - Street 2:
Mailing Address - City:PEDRO
Mailing Address - State:OH
Mailing Address - Zip Code:45659-8773
Mailing Address - Country:US
Mailing Address - Phone:740-479-2373
Mailing Address - Fax:
Practice Address - Street 1:1404 RACE ST STE 202
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-7366
Practice Address - Country:US
Practice Address - Phone:740-471-0741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator