Healthcare Provider Details

I. General information

NPI: 1689712564
Provider Name (Legal Business Name): CHERRE L. FLYNN LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 MAHONING AVE NW
WARREN OH
44483-4605
US

IV. Provider business mailing address

4941 DAMON AVE NW
WARREN OH
44483-1319
US

V. Phone/Fax

Practice location:
  • Phone: 330-395-9563
  • Fax:
Mailing address:
  • Phone: 330-847-9270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI-0005189
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.0005189-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: