Provider Demographics
NPI:1023156817
Name:BERRY WELLS, CHERYL (LPC)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:
Last Name:BERRY WELLS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:CHERYL
Other - Middle Name:GAY
Other - Last Name:LIBBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2 SHANNON CREEK CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5451
Mailing Address - Country:US
Mailing Address - Phone:864-297-1188
Mailing Address - Fax:864-640-8895
Practice Address - Street 1:2 SHANNON CREEK CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5451
Practice Address - Country:US
Practice Address - Phone:864-297-1188
Practice Address - Fax:864-640-8895
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3546101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional