Provider Demographics
NPI:1467694422
Name:SHERRY, LINDSAY A (BCABA)
Entity type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:A
Last Name:SHERRY
Suffix:
Gender:
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3214 CEDARBROOK DR
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33982-1218
Mailing Address - Country:US
Mailing Address - Phone:941-445-2468
Mailing Address - Fax:
Practice Address - Street 1:18215 PAULSON DR UNIT A
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33954-1025
Practice Address - Country:US
Practice Address - Phone:813-720-7529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-07-2349103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst