Provider Demographics
NPI:1558594002
Name:MCDONALD, CHERIE ANNE (MS ED, CAS, NCSP)
Entity Type:Individual
Prefix:MISS
First Name:CHERIE
Middle Name:ANNE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MS ED, CAS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5810 N 49TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-6222
Mailing Address - Country:US
Mailing Address - Phone:623-842-3889
Mailing Address - Fax:623-847-7151
Practice Address - Street 1:5810 N 49TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-6222
Practice Address - Country:US
Practice Address - Phone:623-842-3889
Practice Address - Fax:623-847-7151
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool