Provider Demographics
NPI:1669240255
Name:SHERRELL, RENEE (PH D)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:
Last Name:SHERRELL
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ETON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-2409
Mailing Address - Country:US
Mailing Address - Phone:321-795-0074
Mailing Address - Fax:
Practice Address - Street 1:1 ETON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-2409
Practice Address - Country:US
Practice Address - Phone:321-795-0074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10650101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health