Provider Demographics
NPI:1083771869
Name:LEWIS, SHERRY ANN (LPC)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:ANN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 MILO CIR APT A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3017
Mailing Address - Country:US
Mailing Address - Phone:303-916-8176
Mailing Address - Fax:
Practice Address - Street 1:952 MILO CIR APT A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3017
Practice Address - Country:US
Practice Address - Phone:303-916-8176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3715101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional