Provider Demographics
NPI:1073720660
Name:MCCANE, SHERRY AUTUM (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:AUTUM
Last Name:MCCANE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40507-1004
Mailing Address - Country:US
Mailing Address - Phone:859-233-0444
Mailing Address - Fax:859-233-0144
Practice Address - Street 1:201 MECHANIC ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-1004
Practice Address - Country:US
Practice Address - Phone:859-233-0444
Practice Address - Fax:859-233-0144
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2008-49103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist