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General NPI Number Information
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NPI Number | 1073071445
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Entity Type | Organization
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Legal Business Name | CHERRY TREE COUNSELING PLLC
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Dates
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Enumeration Date | 03/05/2019
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 2704 N BROADWAY ST
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City | POTEAU
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State | OK
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Zip | 74953-5402
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Country | US
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Telephone | 918-839-3458
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Fax |
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Provider Business Mailing Address
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Address Line | 21938 COGGINS RD
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City | POTEAU
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State | OK
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Zip | 74953-8678
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Country | US
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Telephone | 918-839-3458
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Fax |
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Authorized Official
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Title or Position | LPC
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Name | MRS. CHERI LEE MATHEWS
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Credential | MSHR
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Telephone | 918-839-3458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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