MEDICARE: CHERELLE DAVITA MCKEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	104100000X	Social Worker	110243	TX
3	104100000X	Social Worker	13065	SC

General Provider Information

NPI Number	:	1427543313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERELLE DAVITA MCKEE

Provider Business Mailing Address
First Line	:	2819 NW LOOP 410 STE F
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-5105
Country	:	US
Telephone Number	:	210-797-7316
Fax Number	:	210-783-8316

Provider Business Practice Location Address
First Line	:	2819 NW LOOP 410 STE F
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-5105
Country	:	US
Telephone Number	:	210-797-7316
Fax Number	:	210-783-8316

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2018
Last Update Date	:	01/06/2026

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