Provider Demographics
NPI:1295850972
Name:SHERMAN, ELLEN A (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:A
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2499 GLADES RD STE 108
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7260
Mailing Address - Country:US
Mailing Address - Phone:561-361-0670
Mailing Address - Fax:
Practice Address - Street 1:2499 GLADES RD
Practice Address - Street 2:SUITE 108
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7209
Practice Address - Country:US
Practice Address - Phone:561-361-0670
Practice Address - Fax:561-447-8190
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMHC2622101Y00000X
FLLMFT1430101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor