Provider Demographics
NPI:1538794987
Name:CHERRY, KARYN (LMFTA)
Entity type:Individual
Prefix:
First Name:KARYN
Middle Name:
Last Name:CHERRY
Suffix:
Gender:F
Credentials:LMFTA
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 158
Mailing Address - Street 2:
Mailing Address - City:SHERRILLS FORD
Mailing Address - State:NC
Mailing Address - Zip Code:28673-0158
Mailing Address - Country:US
Mailing Address - Phone:828-308-1112
Mailing Address - Fax:
Practice Address - Street 1:525 SAMARITANS RIDGE CT
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2457
Practice Address - Country:US
Practice Address - Phone:828-308-1112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12203A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist