Provider Demographics
NPI:1306211362
Name:ALLISON, SHERRY LYNN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:LYNN
Last Name:ALLISON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:41000 WOODWARD AVE BLDG SUITE350
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-5130
Mailing Address - Country:US
Mailing Address - Phone:248-783-6942
Mailing Address - Fax:248-327-0333
Practice Address - Street 1:41000 WOODWARD AVE BLDG SUITE350
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-5130
Practice Address - Country:US
Practice Address - Phone:248-796-2822
Practice Address - Fax:248-327-0333
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401018263101YP2500X, 103K00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst