Individual
MRS. CHERYL ANN MARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3601 NE RALPH POWELL ROAD, SUITE C, LEE'S SUMMIT, MO 64064
(816) 810-7790
Mailing address
4316 NE MAPLEGATE DRIVE, LEE'S SUMMIT, MO 64064
(816) 916-4827
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2005007633
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37737016
BLUE CROSS BLUE SHIELD
MO
01
—
37737016
BLUECROSS
—
01
—
NOT ISSUED YET
TRI-CARE
MO
Enumeration date
05/10/2007
Last updated
04/27/2010
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