Provider Demographics
NPI:1235469321
Name:STOVER, SHERRI LYNN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:LYNN
Last Name:STOVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1993
Mailing Address - Country:US
Mailing Address - Phone:502-220-8802
Mailing Address - Fax:
Practice Address - Street 1:581 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1993
Practice Address - Country:US
Practice Address - Phone:502-220-8808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1996171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor