Provider Demographics
NPI:1639338361
Name:PINGEL, CHERYL RUTH (LMHC)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:RUTH
Last Name:PINGEL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 W LOWDER ST STE C
Mailing Address - Street 2:
Mailing Address - City:MACCLENNY
Mailing Address - State:FL
Mailing Address - Zip Code:32063-2638
Mailing Address - Country:US
Mailing Address - Phone:904-259-4671
Mailing Address - Fax:904-259-5187
Practice Address - Street 1:84 W LOWDER ST STE C
Practice Address - Street 2:
Practice Address - City:MACCLENNY
Practice Address - State:FL
Practice Address - Zip Code:32063-2638
Practice Address - Country:US
Practice Address - Phone:904-259-4671
Practice Address - Fax:904-259-5187
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9479101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000459900Medicaid
FL000903900Medicaid