Provider Demographics
NPI:1689731804
Name:BEARD, CHERYL KAY (MA)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:KAY
Last Name:BEARD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 E BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-2357
Mailing Address - Country:US
Mailing Address - Phone:480-345-6638
Mailing Address - Fax:480-656-7451
Practice Address - Street 1:1800 E LIBRA DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3216
Practice Address - Country:US
Practice Address - Phone:480-755-7922
Practice Address - Fax:480-656-7451
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT 0282101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health