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General NPI Number Information
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NPI Number | 1588262125
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Entity Type | Individual
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Provider Name | CHERYL JOYCE BOUCHER LPC
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Gender | Female
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 2609 COMMONS BLVD
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City | AUGUSTA
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State | GA
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Zip | 30909-6059
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Country | US
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Telephone | 706-843-6241
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Fax |
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Provider Business Mailing Address
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Address Line | 800 BRIGGS ROAD
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City | NORTH AUGUSTA
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State | SC
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Zip | 29860
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Country | US
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Telephone | 706-524-4846
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 009993
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License Number State | GA
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