Provider Demographics
NPI:1881864007
Name:SHIFFLETT-EVANS, CHERYL DAWN (LPC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:DAWN
Last Name:SHIFFLETT-EVANS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:DAWN
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:5965 S 900 E STE 150
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-1720
Mailing Address - Country:US
Mailing Address - Phone:801-263-7251
Mailing Address - Fax:801-263-7268
Practice Address - Street 1:5965 S 900 E STE 150
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-1720
Practice Address - Country:US
Practice Address - Phone:801-263-7251
Practice Address - Fax:801-263-7268
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5790982-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT107040219101OtherSELECT HEALTH