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NPI Code Detail

MEDICARE: DR. CHERISE DEANN LEREW PHD

MEDICARE: DR. CHERISE DEANN LEREW PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC2200XClinical Child & Adolescent Psychologist532SD
2103TC0700XClinical Psychologist532SD
3103T00000XPsychologistSD
4103TC1900XCounseling Psychologist532SD
5103TS0200XSchool PsychologistSD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184910911
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHERISE DEANN LEREW PHD
Provider Business Mailing Address
First Line : 115 N. 7TH ST.
Second Line : STE 6
City : SPEARFISH
State : SD
Zip : 57783-2710
Country : US
Telephone Number : 605-645-0100
Fax Number : 605-717-1009
Provider Business Practice Location Address
First Line : 115 N. 7TH ST.
Second Line : STE 6
City : SPEARFISH
State : SD
Zip : 57783-2710
Country : US
Telephone Number : 605-645-0100
Fax Number : 605-717-1009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2011
Last Update Date : 06/09/2015

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Directions to “ DR. CHERISE DEANN LEREW PHD” Practice Location

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