Healthcare Provider Details

I. General information

NPI: 1003735176
Provider Name (Legal Business Name): CHEANEY ARCHER CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 GRIMES AVE
OWENSBORO KY
42303-0902
US

IV. Provider business mailing address

1809 GRIMES AVE
OWENSBORO KY
42303-0902
US

V. Phone/Fax

Practice location:
  • Phone: 270-478-1068
  • Fax: 270-478-1069
Mailing address:
  • Phone: 270-478-1068
  • Fax: 270-478-1069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW00001547
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: