Healthcare Provider Details

I. General information

NPI: 1780620500
Provider Name (Legal Business Name): CHER N/A MCCLELLAN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHER SAUER LMHC

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 MARY ESTHER BLVD SUITE 201
MARY ESTHER FL
32569-1972
US

IV. Provider business mailing address

151 MARY ESTHER BLVD SUITE 201
MARY ESTHER FL
32569-1972
US

V. Phone/Fax

Practice location:
  • Phone: 850-862-6030
  • Fax: 850-862-6030
Mailing address:
  • Phone: 850-862-6030
  • Fax: 850-862-6030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH-4071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: