Provider Demographics
NPI:1508909474
Name:SHAMBLIN, SHERRY R (LPCC)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:R
Last Name:SHAMBLIN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:R
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:90 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2301
Mailing Address - Country:US
Mailing Address - Phone:740-593-3682
Mailing Address - Fax:740-594-5642
Practice Address - Street 1:90 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2301
Practice Address - Country:US
Practice Address - Phone:740-593-3682
Practice Address - Fax:740-594-5642
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0003874-SUPV101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)