Provider Demographics
NPI:1730483207
Name:SHERIDAN, DAE CHERYLYN (PHD, LMHC,CRC)
Entity Type:Individual
Prefix:DR
First Name:DAE
Middle Name:CHERYLYN
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:PHD, LMHC,CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 E FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0916
Mailing Address - Country:US
Mailing Address - Phone:813-431-8292
Mailing Address - Fax:
Practice Address - Street 1:7320 E FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33637-0916
Practice Address - Country:US
Practice Address - Phone:813-431-8292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH#7154101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health