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MS. CAROL JEAN CHERICH LPC-LADAC

Addiction Substance Use Disorder

Amarillo, Texas

Provider NPI: 1124026596

Provider Information:
MS. CAROL JEAN CHERICH LPC-LADAC
Gender: F
Not Sole Proprietor

Practice Location:
4401 S COULTER ST APT 1913  AMARILLO, TX 79109 US
Tel: 505-870-1855  Fax: --

Business Mailing Address:
4401 S COULTER ST APT 1913  AMARILLO, TX 79109 US
Tel: 505-870-1855  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
NM0089181
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
NM0101181

Other Provider Identifiers:

IssuerNumberStateType
1124026596NM05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







ADDICTION JOBS TX - Page 1



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