Provider Demographics
NPI:1164065199
Name:SMITH, CHERISH ANNE
Entity type:Individual
Prefix:MRS
First Name:CHERISH
Middle Name:ANNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHERISH
Other - Middle Name:ANNE
Other - Last Name:TRAVNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13035 W LINEBAUGH AVE STE 101F
Mailing Address - Street 2:
Mailing Address - City:WESTCHASE
Mailing Address - State:FL
Mailing Address - Zip Code:33626-4481
Mailing Address - Country:US
Mailing Address - Phone:813-690-2207
Mailing Address - Fax:813-690-2207
Practice Address - Street 1:13035 W LINEBAUGH AVE STE 101F
Practice Address - Street 2:
Practice Address - City:WESTCHASE
Practice Address - State:FL
Practice Address - Zip Code:33626-4481
Practice Address - Country:US
Practice Address - Phone:813-690-2207
Practice Address - Fax:813-690-2207
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2025-11-10
Deactivation Date:2023-08-14
Deactivation Code:
Reactivation Date:2023-10-11
Provider Licenses
StateLicense IDTaxonomies
FLMH25204101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health