Provider Demographics
NPI:1184339236
Name:SHERROD, AARON (LSW)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:
Last Name:SHERROD
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-2231
Mailing Address - Country:US
Mailing Address - Phone:662-299-2457
Mailing Address - Fax:
Practice Address - Street 1:1304 WALNUT ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-2231
Practice Address - Country:US
Practice Address - Phone:662-299-2457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150110163101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor