Provider Demographics
NPI:1073946265
Name:CARRASCO, CHERYL ELIZABETH (LCSW, MSW, BA)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ELIZABETH
Last Name:CARRASCO
Suffix:
Gender:F
Credentials:LCSW, MSW, BA
Other - Prefix:
Other - First Name:LIZ
Other - Middle Name:
Other - Last Name:CARRASCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:801 S RANCHO DR STE C3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3858
Mailing Address - Country:US
Mailing Address - Phone:702-372-2475
Mailing Address - Fax:
Practice Address - Street 1:801 S RANCHO DR STE C3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3858
Practice Address - Country:US
Practice Address - Phone:702-385-2153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7113-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical