Provider Demographics
NPI:1710758172
Name:JONES, SHERRY LYNN (PCSW-1123)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:PCSW-1123
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3207 SPARKS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-6152
Mailing Address - Country:US
Mailing Address - Phone:307-369-4710
Mailing Address - Fax:307-222-0279
Practice Address - Street 1:510 W 28 TH ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001
Practice Address - Country:US
Practice Address - Phone:307-634-9653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPCSW-11231041C0700X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical