Provider Demographics
NPI:1235750142
Name:MACIAS, SHERRY (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:
Last Name:MACIAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 SW RIMROCK WAY STE 201-271
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-2570
Mailing Address - Country:US
Mailing Address - Phone:416-042-6465
Mailing Address - Fax:
Practice Address - Street 1:128 W ANTLER AVE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1852
Practice Address - Country:US
Practice Address - Phone:541-604-2646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7554101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional