MEDICARE: MRS. CHERIE ANN WHITE M.ED. PCC-S

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
1	101Y00000X	Counselor	E0008041	OH
2	101YP2500X	Professional Counselor	E0008041	OH
3	101YM0800X	Mental Health Counselor	E0008041	OH

General Provider Information

NPI Number	:	1316276041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERIE ANN WHITE M.ED. PCC-S

Provider Business Mailing Address
First Line	:	5010 MAYFIELD RD STE 217
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-2692
Country	:	US
Telephone Number	:	216-337-1762
Fax Number	:	440-565-7129

Provider Business Practice Location Address
First Line	:	5010 MAYFIELD RD STE 217
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-2692
Country	:	US
Telephone Number	:	216-337-1762
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2009
Last Update Date	:	09/06/2021

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