MEDICARE: MS. KERRI ELIZABETH CHENEY MS, LPC

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	101YP2500X	Professional Counselor	6272	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6272	OTHER	CO	LICENSED PROFFESSSIONAL COUNSELOR STATE OF COLORADO

General Provider Information

NPI Number	:	1730440843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KERRI ELIZABETH CHENEY MS, LPC

Provider Business Mailing Address
First Line	:	637 E 1ST ST
Second Line	:
City	:	NEW CASTLE
State	:	CO
Zip	:	81647-9466
Country	:	US
Telephone Number	:	970-379-8000
Fax Number	:	970-945-2828

Provider Business Practice Location Address
First Line	:	710 COOPER AVE STE 120
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-3446
Country	:	US
Telephone Number	:	970-379-8000
Fax Number	:	970-945-2828

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

Provider Enumeration Date	:	06/05/2012
Last Update Date	:	06/05/2012

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