Provider Demographics
NPI:1598501587
Name:MALLETT, CHERAMI (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:CHERAMI
Middle Name:
Last Name:MALLETT
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 FM 2127
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:TX
Mailing Address - Zip Code:76431-3838
Mailing Address - Country:US
Mailing Address - Phone:817-914-5117
Mailing Address - Fax:
Practice Address - Street 1:4430 N US HIGHWAY 287
Practice Address - Street 2:
Practice Address - City:ALVORD
Practice Address - State:TX
Practice Address - Zip Code:76225-7917
Practice Address - Country:US
Practice Address - Phone:940-350-9049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98774101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional