Provider Demographics
NPI:1508451071
Name:LASTER, SHERRI (MS,CADCII)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:LASTER
Suffix:
Gender:F
Credentials:MS,CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-6592
Mailing Address - Country:US
Mailing Address - Phone:229-254-5546
Mailing Address - Fax:
Practice Address - Street 1:130 LAUREL LN
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-6592
Practice Address - Country:US
Practice Address - Phone:229-254-5546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)