Provider Demographics
NPI:1447904222
Name:PUGH, CHEYANNE
Entity type:Individual
Prefix:
First Name:CHEYANNE
Middle Name:
Last Name:PUGH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201-2220
Mailing Address - Country:US
Mailing Address - Phone:501-379-4249
Mailing Address - Fax:501-379-4252
Practice Address - Street 1:712 W 3RD ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-2220
Practice Address - Country:US
Practice Address - Phone:501-379-4249
Practice Address - Fax:501-379-4252
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health