Provider Demographics
NPI:1720485097
Name:KING, SHERI (LMHC)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 BASHAW RD
Mailing Address - Street 2:
Mailing Address - City:MOOERS
Mailing Address - State:NY
Mailing Address - Zip Code:12958-4007
Mailing Address - Country:US
Mailing Address - Phone:518-324-7697
Mailing Address - Fax:518-333-9198
Practice Address - Street 1:343 BASHAW RD
Practice Address - Street 2:
Practice Address - City:MOOERS
Practice Address - State:NY
Practice Address - Zip Code:12958-4007
Practice Address - Country:US
Practice Address - Phone:518-324-7697
Practice Address - Fax:518-333-9198
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006655101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health