Provider Demographics
NPI:1144054552
Name:HUMPHRIES, CHEYANN NICOLE
Entity type:Individual
Prefix:
First Name:CHEYANN
Middle Name:NICOLE
Last Name:HUMPHRIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1134
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29342-1134
Mailing Address - Country:US
Mailing Address - Phone:864-279-1366
Mailing Address - Fax:
Practice Address - Street 1:431 S MAIN ST STE 9&10
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-2946
Practice Address - Country:US
Practice Address - Phone:828-289-7612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health