Healthcare Provider Details

I. General information

NPI: 1346084324
Provider Name (Legal Business Name): MONTEOUS JERELL CHEELY LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3755 ADMIRAL DR STE 105A
HIGH POINT NC
27265-1554
US

IV. Provider business mailing address

3755 ADMIRAL DR STE 105A
HIGH POINT NC
27265-1554
US

V. Phone/Fax

Practice location:
  • Phone: 336-673-5097
  • Fax: 336-203-3644
Mailing address:
  • Phone: 336-673-5097
  • Fax: 336-203-3644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number10438
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: