Provider Demographics
NPI:1952480352
Name:SHERRY E. JOHNSON, P.C.
Entity Type:Organization
Organization Name:SHERRY E. JOHNSON, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHD NURSE THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:BS, RN, MS, PHD
Authorized Official - Phone:781-878-6543
Mailing Address - Street 1:200 CORDWAINER DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1671
Mailing Address - Country:US
Mailing Address - Phone:781-878-6543
Mailing Address - Fax:781-871-0306
Practice Address - Street 1:200 CORDWAINER DR
Practice Address - Street 2:SUITE 202
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1671
Practice Address - Country:US
Practice Address - Phone:781-878-6543
Practice Address - Fax:781-871-0306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171110163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPN0004OtherBC/BS
MAPN0004OtherBC/BS