Provider Demographics
NPI:1003262080
Name:WALTER, SHERRIE L (LPC, LPCC)
Entity Type:Individual
Prefix:
First Name:SHERRIE
Middle Name:L
Last Name:WALTER
Suffix:
Gender:F
Credentials:LPC, LPCC
Other - Prefix:
Other - First Name:SHERRIE
Other - Middle Name:L
Other - Last Name:MEREDITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:571 BRAUND ST
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-8556
Mailing Address - Country:US
Mailing Address - Phone:608-785-7000
Mailing Address - Fax:608-785-7477
Practice Address - Street 1:571 BRAUND ST
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-8556
Practice Address - Country:US
Practice Address - Phone:608-785-7000
Practice Address - Fax:608-785-7477
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-10
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6223-125101YP2500X
MNCC01275101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100056202Medicaid