Provider Demographics
NPI:1225509532
Name:SHERMAN, JESSICA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 N OLD WOODWARD AVE STE LL4
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-5324
Mailing Address - Country:US
Mailing Address - Phone:248-496-8908
Mailing Address - Fax:
Practice Address - Street 1:280 N OLD WOODWARD AVE STE LL4
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-5324
Practice Address - Country:US
Practice Address - Phone:248-496-8908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-12
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016579101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health