Provider Demographics
NPI:1922390301
Name:DAILEY, CHERYL ZOE (MA, LMHC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ZOE
Last Name:DAILEY
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 JORGENSON RD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516-3029
Mailing Address - Country:US
Mailing Address - Phone:360-561-6325
Mailing Address - Fax:
Practice Address - Street 1:2935 JORGENSON RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516-3029
Practice Address - Country:US
Practice Address - Phone:360-561-6325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60189514101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health