Provider Demographics
NPI:1861827289
Name:GREENLAW, SHERILYN DANETTE (MA, MFTI)
Entity Type:Individual
Prefix:
First Name:SHERILYN
Middle Name:DANETTE
Last Name:GREENLAW
Suffix:
Gender:F
Credentials:MA, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2185 BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-5312
Mailing Address - Country:US
Mailing Address - Phone:530-538-8221
Mailing Address - Fax:
Practice Address - Street 1:2185 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-5312
Practice Address - Country:US
Practice Address - Phone:530-538-8221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01723411Medicare PIN