Provider Demographics
NPI:1659386084
Name:SHERROD, NANCY BETH (PHD, PLLC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:BETH
Last Name:SHERROD
Suffix:
Gender:F
Credentials:PHD, PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13791 E RICE PL
Mailing Address - Street 2:SUITE 104
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1057
Mailing Address - Country:US
Mailing Address - Phone:303-898-7583
Mailing Address - Fax:303-481-4478
Practice Address - Street 1:13791 E RICE PL
Practice Address - Street 2:SUITE 104
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1057
Practice Address - Country:US
Practice Address - Phone:303-898-7583
Practice Address - Fax:303-481-4478
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2890103TA0400X, 103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO806871Medicare ID - Type Unspecified