Provider Demographics
NPI:1669752259
Name:MUSGROVE, SHERYL LYNNE (MED, PLPC, NCC)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:LYNNE
Last Name:MUSGROVE
Suffix:
Gender:F
Credentials:MED, PLPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13160 COUNTY ROAD 3610
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:MO
Mailing Address - Zip Code:65559
Mailing Address - Country:US
Mailing Address - Phone:573-265-3251
Mailing Address - Fax:573-265-0156
Practice Address - Street 1:13160 COUNTY ROAD 3610
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:MO
Practice Address - Zip Code:65559-9700
Practice Address - Country:US
Practice Address - Phone:573-265-3251
Practice Address - Fax:573-265-0156
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011020135101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional