Provider Demographics
NPI:1649398413
Name:CHALONER, CHERYL (MSW)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:CHALONER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 E 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5309
Mailing Address - Country:US
Mailing Address - Phone:970-259-3030
Mailing Address - Fax:
Practice Address - Street 1:501 AIRPORT DR STE 253
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-2646
Practice Address - Country:US
Practice Address - Phone:505-325-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-060711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical