Provider Demographics
NPI:1184227365
Name:SHERMAN-SPORRONG, MEAGAN (LPC, MDIV)
Entity Type:Individual
Prefix:MS
First Name:MEAGAN
Middle Name:
Last Name:SHERMAN-SPORRONG
Suffix:
Gender:F
Credentials:LPC, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4519 N MEADE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-3004
Mailing Address - Country:US
Mailing Address - Phone:773-885-9686
Mailing Address - Fax:
Practice Address - Street 1:205 EAST 5TH AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563
Practice Address - Country:US
Practice Address - Phone:331-457-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178013834101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional