Basic Information
| Provider Information | |||||||||
| NPI: | 1013094093 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HESS | ||||||||
| FirstName: | CHERYL ANN | ||||||||
| MiddleName: | |||||||||
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| Credential: | PMHNP, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2715 COLONIAL DR | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292036818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9193540840 | ||||||||
| FaxNumber: | 8778406694 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 RIDGEFIELD BLVD STE 250 | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288062287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286336070 | ||||||||
| FaxNumber: | 8286336073 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 01/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LSW0000003700 | TN | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 163WP0809X | APN0000017669 | TN | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult | 363LP0808X | 5009551 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LP0808X | 202112142NP-PP | OR | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LP0808X | 18764 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 3927844 | 05 | TN | MEDICAID | NP2775 | 05 | SC | MEDICAID | P01577818 | 01 | SC | RAILROAD MEDICARE | OTHER | Q023142 | 05 | TN | MEDICAID |