Healthcare Provider Details

I. General information

NPI: 1780941930
Provider Name (Legal Business Name): CHERYL B HAIR LPC, LCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1297 PROFESSIONAL DR STE 102
MYRTLE BEACH SC
29577-5713
US

IV. Provider business mailing address

PO BOX 532
WHITEVILLE NC
28472-0532
US

V. Phone/Fax

Practice location:
  • Phone: 843-756-3008
  • Fax: 888-653-4133
Mailing address:
  • Phone: 910-231-1220
  • Fax: 888-653-4133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9849
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: