Provider Demographics
NPI:1417463795
Name:EDWARDS, SHERRI ELAINE (MS, LCDC, QSAP,CART,)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:ELAINE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MS, LCDC, QSAP,CART,
Other - Prefix:MRS
Other - First Name:SHERRI'
Other - Middle Name:ELAINE
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LCDC,QSAP,TDEOP
Mailing Address - Street 1:5230 POMANDER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-3148
Mailing Address - Country:US
Mailing Address - Phone:832-264-6146
Mailing Address - Fax:
Practice Address - Street 1:2600 S LOOP W STE 322
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2886
Practice Address - Country:US
Practice Address - Phone:832-649-4674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-21
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9683101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX823291377OtherTAXID