Provider Demographics
NPI:1578838090
Name:NORMANDIN, SHERMAN (PHD)
Entity Type:Individual
Prefix:
First Name:SHERMAN
Middle Name:
Last Name:NORMANDIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2534 17TH AVE S STE E
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-5215
Mailing Address - Country:US
Mailing Address - Phone:701-885-4551
Mailing Address - Fax:701-757-1351
Practice Address - Street 1:2534 17TH AVE S STE E
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-5215
Practice Address - Country:US
Practice Address - Phone:701-885-4551
Practice Address - Fax:701-757-1351
Is Sole Proprietor?:No
Enumeration Date:2012-03-16
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND464103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND16760Medicaid
ND16760Medicaid