Provider Demographics
NPI:1780749630
Name:DESCOTEAX, SHERRY (LSCSW)
Entity type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:
Last Name:DESCOTEAX
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 E CRAWFORD ST
Mailing Address - Street 2:STE 209
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-5116
Mailing Address - Country:US
Mailing Address - Phone:785-502-5283
Mailing Address - Fax:785-502-5283
Practice Address - Street 1:631 E CRAWFORD ST
Practice Address - Street 2:STE 209
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-5116
Practice Address - Country:US
Practice Address - Phone:785-823-1245
Practice Address - Fax:785-823-1940
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS23091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1041C0700XOtherTAXONOMY