Provider Demographics
NPI:1871999664
Name:PETE, CHERYL (LPC, ART THERAPIST)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:PETE
Suffix:
Gender:F
Credentials:LPC, ART THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 E BAGLEY RD
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-2058
Mailing Address - Country:US
Mailing Address - Phone:330-618-9469
Mailing Address - Fax:
Practice Address - Street 1:401 TUSCARAWAS ST W STE 501
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44702-2045
Practice Address - Country:US
Practice Address - Phone:330-618-9469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1400543101YP2500X
18-275221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional