Provider Demographics
NPI:1609629732
Name:SHERROD, HOLLY L (LICSW-S, PIP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:L
Last Name:SHERROD
Suffix:
Gender:F
Credentials:LICSW-S, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-3195
Mailing Address - Country:US
Mailing Address - Phone:256-366-0343
Mailing Address - Fax:
Practice Address - Street 1:301 JACKSON DR
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-3195
Practice Address - Country:US
Practice Address - Phone:256-366-0343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1569-4363C-S1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical