Provider Demographics
NPI:1750168019
Name:GEORGE, SHERRY THOMAS (LCSW)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:THOMAS
Last Name:GEORGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2313 MESA OAK TRL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-4720
Mailing Address - Country:US
Mailing Address - Phone:469-964-4398
Mailing Address - Fax:
Practice Address - Street 1:2313 MESA OAK TRL
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-4720
Practice Address - Country:US
Practice Address - Phone:469-964-4398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX420471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical