Provider Demographics
NPI:1164630745
Name:SOMERSHOE, SHERRIE LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHERRIE
Middle Name:LEE
Last Name:SOMERSHOE
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 1:40711 N ROBINSON DR
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-2504
Mailing Address - Country:US
Mailing Address - Phone:623-340-4249
Mailing Address - Fax:
Practice Address - Street 1:13985 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3625
Practice Address - Country:US
Practice Address - Phone:623-340-4249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3822103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical