Provider Demographics
NPI:1831382092
Name:SCOTT, SHERRILL ANN (LPC)
Entity type:Individual
Prefix:MS
First Name:SHERRILL
Middle Name:ANN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5303 E 12TH ST
Mailing Address - Street 2:#25
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-5304
Mailing Address - Country:US
Mailing Address - Phone:405-209-3048
Mailing Address - Fax:
Practice Address - Street 1:7010 S YALE AVE
Practice Address - Street 2:STE 215
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5713
Practice Address - Country:US
Practice Address - Phone:918-492-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1337101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional