Provider Demographics
NPI:1033300793
Name:DODRILL, SHARYN L (LCSW, PIP)
Entity Type:Individual
Prefix:MS
First Name:SHARYN
Middle Name:L
Last Name:DODRILL
Suffix:
Gender:F
Credentials:LCSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-1754
Mailing Address - Country:US
Mailing Address - Phone:256-582-2372
Mailing Address - Fax:
Practice Address - Street 1:2020 HENRY ST
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-1754
Practice Address - Country:US
Practice Address - Phone:256-582-2372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1001C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALR75601Medicare UPIN