Healthcare Provider Details

I. General information

NPI: 1861852089
Provider Name (Legal Business Name): CHERYL MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4520 S SHERWOOD FRST # 245
BATON ROUGE LA
70816-6400
US

IV. Provider business mailing address

4520 S SHERWOOD FRST STE 245
BATON ROUGE LA
70816-6400
US

V. Phone/Fax

Practice location:
  • Phone: 225-405-1879
  • Fax:
Mailing address:
  • Phone: 225-405-1879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2735
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5773
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number84392
License Number StateMS
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: