Provider Demographics
NPI:1992575708
Name:SHERIDAN, WARREN MARTIN JR (MA, LPC-A)
Entity type:Individual
Prefix:MR
First Name:WARREN
Middle Name:MARTIN
Last Name:SHERIDAN
Suffix:JR
Gender:M
Credentials:MA, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 BARBUDA ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-2401
Mailing Address - Country:US
Mailing Address - Phone:210-807-1806
Mailing Address - Fax:
Practice Address - Street 1:215 BARBUDA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-2401
Practice Address - Country:US
Practice Address - Phone:210-807-1806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93116101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health