Healthcare Provider Details

I. General information

NPI: 1023393998
Provider Name (Legal Business Name): STEVEN CHEATHAM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2011
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 ASHLEY CIR STE 209
BOWLING GREEN KY
42104-5810
US

IV. Provider business mailing address

1725 ASHLEY CIR STE 209
BOWLING GREEN KY
42104-5810
US

V. Phone/Fax

Practice location:
  • Phone: 270-282-3012
  • Fax: 270-495-1039
Mailing address:
  • Phone: 270-282-3012
  • Fax: 270-495-1039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: