Provider Demographics
NPI:1912374976
Name:SMITH, SHERI RYLAND (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:RYLAND
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHERI
Other - Middle Name:R
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6303 MULLIN ST
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-6677
Mailing Address - Country:US
Mailing Address - Phone:561-601-1647
Mailing Address - Fax:
Practice Address - Street 1:900 E INDIANTOWN RD STE 310
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5153
Practice Address - Country:US
Practice Address - Phone:561-601-1647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW11475101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health