Doctor Name: | CHERYL A ST JOHN |
NPI Number: | 1013186816 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 0701004122 |
Business Practice Address: | 289 Independence Blvd Suite 138 Virginia Beach, VA - 234625493 |
Business Phone Number: | 7573854980 |
Business Fax Number: | |
Mailing Address: | 1717 Placid Ct, VIRGINIA BEACH |
State: | VA |
Postal Code: | 234533724 |
Phone Number: | 7574304373 |
Fax Number: | |
NPI Enumeration Date: | 02/26/2008 |
NPI Last Update Date: | 02/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0701004122 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |