Provider Demographics
NPI:1467645804
Name:GIFFORD, SHERMAN W (LPC)
Entity Type:Individual
Prefix:
First Name:SHERMAN
Middle Name:W
Last Name:GIFFORD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4807 RADFORD AVE
Mailing Address - Street 2:SUITE #106
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3539
Mailing Address - Country:US
Mailing Address - Phone:804-278-9151
Mailing Address - Fax:804-278-9221
Practice Address - Street 1:4807 RADFORD AVE
Practice Address - Street 2:SUITE #106
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3539
Practice Address - Country:US
Practice Address - Phone:804-278-9151
Practice Address - Fax:804-278-9221
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003740101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional