Provider Demographics
NPI:1346645520
Name:CARPENTER, CHERYL DENISE (MS)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:DENISE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14036 FAIRWAY ISLAND DR
Mailing Address - Street 2:APT 1512
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-5235
Mailing Address - Country:US
Mailing Address - Phone:407-482-2965
Mailing Address - Fax:
Practice Address - Street 1:120 S BUMBY AVE UNIT A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-7412
Practice Address - Country:US
Practice Address - Phone:407-235-8151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health