Provider Demographics
NPI:1396836151
Name:STEPHENS, SHERRI (LCMFT, LCP)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LCMFT, LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 E CENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-6601
Mailing Address - Country:US
Mailing Address - Phone:620-231-1530
Mailing Address - Fax:
Practice Address - Street 1:212 E 5TH ST
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-4046
Practice Address - Country:US
Practice Address - Phone:620-235-7151
Practice Address - Fax:620-235-7154
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS256103T00000X
KS218106H00000X
KS103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool