Provider Demographics
NPI:1427413277
Name:CHECKETT, JOHN (MSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CHECKETT
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8895 145TH DR
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32060-6219
Mailing Address - Country:US
Mailing Address - Phone:386-330-0114
Mailing Address - Fax:
Practice Address - Street 1:8895 145TH DR
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32060-6219
Practice Address - Country:US
Practice Address - Phone:386-330-0114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor