Provider Demographics
NPI:1770836777
Name:AGARD, SHERRY DENISE (MS, LPC, NCC, CLC)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:DENISE
Last Name:AGARD
Suffix:
Gender:F
Credentials:MS, LPC, NCC, CLC
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:DENISE
Other - Last Name:AGARD-RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:114 DALTREY CT
Mailing Address - Street 2:
Mailing Address - City:MOUNTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17554-1875
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1055 S. HOUSTON, AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127
Practice Address - Country:US
Practice Address - Phone:918-921-3200
Practice Address - Fax:918-921-3294
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2014-11-06
Deactivation Date:2013-05-14
Deactivation Code:
Reactivation Date:2013-12-11
Provider Licenses
StateLicense IDTaxonomies
PA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor