Healthcare Provider Details

I. General information

NPI: 1972758878
Provider Name (Legal Business Name): JEREMY MICHAEL CHERRY LPCC-S, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1084 S MAIN ST STE A
BOWLING GREEN OH
43402-4740
US

IV. Provider business mailing address

1084 S MAIN ST STE A
BOWLING GREEN OH
43402-4740
US

V. Phone/Fax

Practice location:
  • Phone: 419-352-4624
  • Fax: 419-936-7606
Mailing address:
  • Phone: 419-352-4624
  • Fax: 419-936-7606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.1100186-SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM.1200031
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: