Provider Demographics
NPI:1417545708
Name:DICKERSON, SHERRIA S (MA MFT)
Entity Type:Individual
Prefix:
First Name:SHERRIA
Middle Name:S
Last Name:DICKERSON
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-1601
Mailing Address - Country:US
Mailing Address - Phone:317-873-8140
Mailing Address - Fax:
Practice Address - Street 1:220 S ELM ST
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-1601
Practice Address - Country:US
Practice Address - Phone:317-873-8140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional