Provider Demographics
NPI:1477705218
Name:MILLER, SHERRY (MS, LPC, LMHC, LCPC)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, LPC, LMHC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 SW 14TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-2206
Mailing Address - Country:US
Mailing Address - Phone:239-284-6925
Mailing Address - Fax:
Practice Address - Street 1:2100 SW 14TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-2206
Practice Address - Country:US
Practice Address - Phone:239-284-6925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4354101YP2500X
WI15681-132101YA0400X
OK649101YA0400X
FLMH13900101YP2500X
WI4869-125101YP2500X
OK4773101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100027401Medicaid
OK200231200AMedicaid