Individual
CHERYL BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCASA
Contact information
Practice address
690 LAVA TRL, FAYETTEVILLE, NC 28311-1920
(910) 286-5826
Mailing address
690 LAVA TRL, FAYETTEVILLE, NC 28311-1920
(910) 286-5826
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2464A
NC
1041C0700X
Clinical Social Worker
P004629
NC
Other
Enumeration date
03/04/2009
Last updated
01/28/2013
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