Provider Demographics
NPI:1275146722
Name:CHERYL A PEPPERS PHD
Entity Type:Organization
Organization Name:CHERYL A PEPPERS PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEPPERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:941-961-4818
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:941-342-1653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty