Provider Demographics
NPI:1932293289
Name:HARRIS, SHERRY L (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:L
Last Name:HARRIS
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 1:3286 ROCKHAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-4045
Mailing Address - Country:US
Mailing Address - Phone:810-441-0669
Mailing Address - Fax:
Practice Address - Street 1:89 W SOUTH BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1612
Practice Address - Country:US
Practice Address - Phone:800-693-1916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007905101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1007731OtherMCLAREN HEALTH ADVANTAGE
MI750910711OtherBCBSM
MI1007731OtherMCLAREN HEALTH PLAN
MI211705242Medicaid