Provider Demographics
NPI:1922537356
Name:SHERRILL, LINDA GAIL (LPC)
Entity Type:Individual
Prefix:PROF
First Name:LINDA
Middle Name:GAIL
Last Name:SHERRILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 E LAWRENCE AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-2284
Mailing Address - Country:US
Mailing Address - Phone:517-416-3148
Mailing Address - Fax:
Practice Address - Street 1:114 E LAWRENCE AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813
Practice Address - Country:US
Practice Address - Phone:517-416-3148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017744101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401015909OtherBOARD OF COUNSELING PROFESSIONAL LICENSE