Provider Demographics
NPI:1760145049
Name:HERNANDEZ, SHERRY (LCDCI)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LCDCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 HEIMER RD APT 616
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4891
Mailing Address - Country:US
Mailing Address - Phone:210-845-7118
Mailing Address - Fax:
Practice Address - Street 1:403 HEIMER RD APT 616
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4891
Practice Address - Country:US
Practice Address - Phone:210-845-7118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty