Healthcare Provider Details

I. General information

NPI: 1568644615
Provider Name (Legal Business Name): DONALD GILBERT CHERMS SR. PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DONALD GILBERT CHERMS SR. PH.D

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 04/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 HIGHWAY 154
NEWNAN GA
30265-6121
US

IV. Provider business mailing address

19 RAYNER DR
NEWNAN GA
30265-1984
US

V. Phone/Fax

Practice location:
  • Phone: 470-955-6171
  • Fax:
Mailing address:
  • Phone: 470-955-6171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number104571-CBCCDC
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC0911091703
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: