Provider Demographics
NPI:1790771251
Name:FORSYTH, SHERRY LYNN (MC, LPC)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:LYNN
Last Name:FORSYTH
Suffix:
Gender:F
Credentials:MC, LPC
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:LYNN
Other - Last Name:BURK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16791 ROLLING HILLS PLACE
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134
Mailing Address - Country:US
Mailing Address - Phone:303-840-4243
Mailing Address - Fax:303-840-4241
Practice Address - Street 1:16791 ROLLING HILLS PLACE
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:303-840-4243
Practice Address - Fax:303-840-4241
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC -1730101YP2500X
AZ4906101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional