Healthcare Provider Details

I. General information

NPI: 1104063130
Provider Name (Legal Business Name): CHERYL MARYE ALLEN MS, LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHERYL MARYE BAKER MS, LPCC

II. Dates (important events)

Enumeration Date: 01/13/2009
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 NW 21ST AVE
CAPE CORAL FL
33993-5984
US

IV. Provider business mailing address

1902 NW 21ST AVE
CAPE CORAL FL
33993-5984
US

V. Phone/Fax

Practice location:
  • Phone: 614-870-6670
  • Fax: 614-343-1538
Mailing address:
  • Phone: 614-870-6670
  • Fax: 614-343-1538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11072541
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC0000004166
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE0500464
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: