Provider Demographics
NPI:1407851579
Name:STERN, SHERRY L (PC)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:L
Last Name:STERN
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:L
Other - Last Name:INMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PCC
Mailing Address - Street 1:PO BOX 643
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0643
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:200 UNION SQ
Practice Address - Street 2:STE 6
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3033
Practice Address - Country:US
Practice Address - Phone:740-706-1638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC7790101YP2500X
OHE0007790101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional