Provider Demographics
NPI:1063842292
Name:SHERIDAN-NORMANN, ANITA (LPC-S, NCC, BC-TMH)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:SHERIDAN-NORMANN
Suffix:
Gender:F
Credentials:LPC-S, NCC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78680-0595
Mailing Address - Country:US
Mailing Address - Phone:512-289-4619
Mailing Address - Fax:888-974-1214
Practice Address - Street 1:407 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5831
Practice Address - Country:US
Practice Address - Phone:512-200-3635
Practice Address - Fax:888-974-1214
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2022-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67964101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional