Provider Demographics
NPI:1629419395
Name:SHERRY, HEATHER RENA (LMSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RENA
Last Name:SHERRY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:RENA
Other - Last Name:MCKAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:827 HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48370-2717
Mailing Address - Country:US
Mailing Address - Phone:586-604-3685
Mailing Address - Fax:
Practice Address - Street 1:450 BREWER RD
Practice Address - Street 2:
Practice Address - City:LEONARD
Practice Address - State:MI
Practice Address - Zip Code:48367-4008
Practice Address - Country:US
Practice Address - Phone:586-604-3685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010943041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical