Provider Demographics
NPI:1982611075
Name:TATRO, CHERYL C (LPC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:C
Last Name:TATRO
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 1:301 HESTERS CROSSING RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-6946
Mailing Address - Country:US
Mailing Address - Phone:512-310-8480
Mailing Address - Fax:512-310-1580
Practice Address - Street 1:301 HESTERS CROSSING RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-6946
Practice Address - Country:US
Practice Address - Phone:512-310-8480
Practice Address - Fax:512-310-1580
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13469101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
272395000 OR IP55097OtherMAGELLAN
159304OtherVALUE OPTIONS
TX3865LCOtherBCBS