Healthcare Provider Details

I. General information

NPI: 1043883085
Provider Name (Legal Business Name): STEPHENS WHITEHURST CHERRY MS, CRC, LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHENS TAYLOR WHITEHURST MS, CRC, LCMHC

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12305 KENDALL RIDGE CT
DURHAM NC
27703-8541
US

IV. Provider business mailing address

12305 KENDALL RIDGE CT
DURHAM NC
27703-8541
US

V. Phone/Fax

Practice location:
  • Phone: 919-537-9763
  • Fax:
Mailing address:
  • Phone: 919-537-9763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number16612
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: