Individual provider Active NPI

Janice W Cheatham, LCSW

  • Psychologist
  • Yuma, AZ
National Provider Identifier
1215023221
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LCSW0111 Issued in AZ
Practice address
544 E 16TH St
Yuma, AZ 85365-2028
Phone
(928) 329-9115
Fax
(928) 782-6661
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LCSW0111 AZ Primary

Addresses

Primary practice location

544 E 16TH St
Yuma, AZ 85365-2028

Mailing address

544 E 16TH St
Yuma, AZ 85365-2028
Phone (928) 329-9115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW0111AZMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215023221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 E 16TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853652028",
            "telephone_number": "928-329-9115",
            "fax_number": "928-782-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 E 16TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853652028",
            "telephone_number": "928-329-9115",
            "fax_number": "928-782-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATHAM",
        "first_name": "JANICE",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "LCSW0111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.