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NPI Code Detail

MEDICARE: JAY A, CHERRY

MEDICARE: JAY A, CHERRY
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
1101YP2500XProfessional Counselor15722TX
2101Y00000XCounselor15722TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881831840
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAY A, CHERRY
Provider Business Mailing Address
First Line : 901 AVENUE C NW
Second Line :
City : CHILDRESS
State : TX
Zip : 79201-4319
Country : US
Telephone Number : 940-937-6406
Fax Number : 940-937-2531
Provider Business Practice Location Address
First Line : 4635 SOUTHWEST FWY STE 635
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7112
Country : US
Telephone Number : 713-850-0049
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2009
Last Update Date : 06/12/2024

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Directions to “ JAY A, CHERRY ” Practice Location

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