Provider Demographics
NPI:1174754535
Name:PREVOT, CHERYL ANN (MSSW)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ANN
Last Name:PREVOT
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:MISS
Other - First Name:CHERYL
Other - Middle Name:ANN
Other - Last Name:CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6004 N BELMONT WAY
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5502
Mailing Address - Country:US
Mailing Address - Phone:303-841-4881
Mailing Address - Fax:
Practice Address - Street 1:19673 SOLAR CIR
Practice Address - Street 2:SUITE #202
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7373
Practice Address - Country:US
Practice Address - Phone:720-220-6005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW 9890611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical