Provider Demographics
NPI:1356069660
Name:SHERMAN, AYISHA (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:AYISHA
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 DAVIS RD STE D
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-5071
Mailing Address - Country:US
Mailing Address - Phone:706-550-8778
Mailing Address - Fax:
Practice Address - Street 1:149 DAVIS RD STE D
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-5071
Practice Address - Country:US
Practice Address - Phone:706-550-8778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013153101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health