Provider Demographics
NPI:1558772202
Name:PINKARD, CHERONDA
Entity type:Individual
Prefix:
First Name:CHERONDA
Middle Name:
Last Name:PINKARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHERONDA
Other - Middle Name:
Other - Last Name:CARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:348 REGAL ROBIN WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-1205
Mailing Address - Country:US
Mailing Address - Phone:708-856-1092
Mailing Address - Fax:
Practice Address - Street 1:348 REGAL ROBIN WAY
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-1205
Practice Address - Country:US
Practice Address - Phone:708-856-1092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health