Provider Demographics
NPI:1548606320
Name:MCRILL, SHERRY ELLEN (MA,LLP)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:ELLEN
Last Name:MCRILL
Suffix:
Gender:F
Credentials:MA,LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1150
Mailing Address - Country:US
Mailing Address - Phone:313-929-0159
Mailing Address - Fax:
Practice Address - Street 1:2900 CONNER ST
Practice Address - Street 2:BLDG A
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48215-2407
Practice Address - Country:US
Practice Address - Phone:313-824-5639
Practice Address - Fax:313-824-5590
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006762103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling