Provider Demographics
NPI:1063814689
Name:PEPPERS, CHERYL (LCSW)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:
Last Name:PEPPERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5825
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-5825
Mailing Address - Country:US
Mailing Address - Phone:941-961-4818
Mailing Address - Fax:
Practice Address - Street 1:73 S PALM AVE STE 215
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-5612
Practice Address - Country:US
Practice Address - Phone:941-961-4818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 122481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical