Provider Demographics
NPI:1912074063
Name:CURRENT, CHERYL JEREE (MHDL)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:JEREE
Last Name:CURRENT
Suffix:
Gender:F
Credentials:MHDL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9649
Mailing Address - Country:US
Mailing Address - Phone:704-521-4977
Mailing Address - Fax:704-521-8541
Practice Address - Street 1:2633 WEST BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-6705
Practice Address - Country:US
Practice Address - Phone:704-521-4977
Practice Address - Fax:704-521-8541
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4980101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102996Medicaid