Basic Information
| Provider Information | |||||||||
| NPI: | 1619122686 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PICKERING | ||||||||
| FirstName: | CHERYL | ||||||||
| MiddleName: | WALSH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MSW, LSCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22214 D. ST | ||||||||
| Address2: | STROTHERFIELD | ||||||||
| City: | WINFIELD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 67156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6204424540 | ||||||||
| FaxNumber: | 6204424559 | ||||||||
| Practice Location | |||||||||
| Address1: | 22214 D. ST | ||||||||
| Address2: | STROTHERFIELD | ||||||||
| City: | WINFIELD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 67156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6204424540 | ||||||||
| FaxNumber: | 6204424559 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2008 | ||||||||
| LastUpdateDate: | 11/18/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | LSCSW3849 | KS | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.