Provider Demographics
NPI:1609399153
Name:PLEISS, SHERYL JAYNE (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:SHERYL
Middle Name:JAYNE
Last Name:PLEISS
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:DR
Other - First Name:SHERYL
Other - Middle Name:JAYNE
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LP
Mailing Address - Street 1:1419 BETHESDA CIR
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-4749
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6640 SHADY OAK RD STE 375
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7834
Practice Address - Country:US
Practice Address - Phone:207-522-5497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6120103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist