Provider Demographics
NPI:1952978595
Name:SMITH, SHERYL ANDREA (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:ANDREA
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1772 MELBOURNE LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60503-7601
Mailing Address - Country:US
Mailing Address - Phone:630-410-9550
Mailing Address - Fax:
Practice Address - Street 1:1772 MELBOURNE LN
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60503-7601
Practice Address - Country:US
Practice Address - Phone:630-410-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.014777101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional