Provider Demographics
NPI:1740759141
Name:JOYCE, CHERYL ANN
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:JOYCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 SPICED WINE AVE UNIT 17101
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-0173
Mailing Address - Country:US
Mailing Address - Phone:702-497-6723
Mailing Address - Fax:
Practice Address - Street 1:6531 ANNIE OAKLEY DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-2166
Practice Address - Country:US
Practice Address - Phone:702-405-7323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4917103K00000X, 101YS0200X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician