Provider Demographics
NPI:1497372635
Name:EVERAGE, CHERYL (MS)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:EVERAGE
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 1:3465 W CRAIG RD STE C
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-5121
Mailing Address - Country:US
Mailing Address - Phone:702-530-2749
Mailing Address - Fax:
Practice Address - Street 1:1901 LITTLE BOW AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-2008
Practice Address - Country:US
Practice Address - Phone:323-578-6959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-04
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00584-S101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)