Provider Demographics
NPI:1174690788
Name:KERR, SHARON LAMOYNE (PH D)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LAMOYNE
Last Name:KERR
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:SHARI
Other - Middle Name:LAMOYNE
Other - Last Name:KERR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2220 W 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4105
Mailing Address - Country:US
Mailing Address - Phone:405-372-1988
Mailing Address - Fax:405-624-1988
Practice Address - Street 1:2220 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4105
Practice Address - Country:US
Practice Address - Phone:405-372-1988
Practice Address - Fax:405-624-1988
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK997103T00000X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200021990AMedicaid