Provider Demographics
NPI:1659415602
Name:SHERRER, SANTASHA LAVETTE
Entity Type:Individual
Prefix:MS
First Name:SANTASHA
Middle Name:LAVETTE
Last Name:SHERRER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4942 FORREST RUN
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-2793
Mailing Address - Country:US
Mailing Address - Phone:404-396-0680
Mailing Address - Fax:
Practice Address - Street 1:8201 HAZELBRAND RD NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-1510
Practice Address - Country:US
Practice Address - Phone:770-787-3977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health