Healthcare Provider Details

I. General information

NPI: 1942127089
Provider Name (Legal Business Name): CEDAR TRAIL COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S 13TH ST STE A
GRIFFIN GA
30224-2704
US

IV. Provider business mailing address

210 S 13TH ST STE A
GRIFFIN GA
30224-2704
US

V. Phone/Fax

Practice location:
  • Phone: 404-451-6488
  • Fax:
Mailing address:
  • Phone: 404-451-6488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA SHERROD
Title or Position: OWNER
Credential:
Phone: 404-451-6488