Provider Demographics
NPI:1700543436
Name:HENRY, SHERYL NADEEN
Entity Type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:NADEEN
Last Name:HENRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 FRENCH CREEK RD APT 6
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4363
Mailing Address - Country:US
Mailing Address - Phone:813-512-9545
Mailing Address - Fax:
Practice Address - Street 1:1809 FRENCH CREEK RD APT 6
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4363
Practice Address - Country:US
Practice Address - Phone:813-512-9545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19719101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health