Provider Demographics
NPI:1710020110
Name:GRISMER, SHERRY L (LPC-MH; LAC)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:L
Last Name:GRISMER
Suffix:
Gender:F
Credentials:LPC-MH; LAC
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:L
Other - Last Name:SENGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-MH; LAC
Mailing Address - Street 1:6140 CURAE LANE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108
Mailing Address - Country:US
Mailing Address - Phone:605-504-2227
Mailing Address - Fax:605-504-2223
Practice Address - Street 1:4400 W 69TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8170
Practice Address - Country:US
Practice Address - Phone:605-322-4065
Practice Address - Fax:605-322-4060
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLAC2051198101YA0400X
SDLPC-MH30678101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health