Provider Demographics
NPI:1730440843
Name:CHENEY, KERRI ELIZABETH (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:KERRI
Middle Name:ELIZABETH
Last Name:CHENEY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:CO
Mailing Address - Zip Code:81647-9466
Mailing Address - Country:US
Mailing Address - Phone:970-379-8000
Mailing Address - Fax:970-945-2828
Practice Address - Street 1:710 COOPER AVE STE 120
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-3446
Practice Address - Country:US
Practice Address - Phone:970-379-8000
Practice Address - Fax:970-945-2828
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6272101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO6272OtherLICENSED PROFFESSSIONAL COUNSELOR STATE OF COLORADO