Provider Demographics
NPI:1083379465
Name:ROYSTER, SHERYL (LMSW)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:ROYSTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:
Other - Last Name:ROYSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:1996 MORNING WALK NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-6454
Mailing Address - Country:US
Mailing Address - Phone:195-150-0741
Mailing Address - Fax:
Practice Address - Street 1:1996 MORNING WALK NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-6454
Practice Address - Country:US
Practice Address - Phone:951-500-7417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW008994104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker