Basic Information
| Provider Information | |||||||||
| NPI: | 1073020970 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KARDMONGMEE | ||||||||
| FirstName: | SHERRY | ||||||||
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| Credential: | RN, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 109 N PLAINS RD APT 4 | ||||||||
| Address2: | |||||||||
| City: | THE PLAINS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 457802001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2085901552 | ||||||||
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| Practice Location | |||||||||
| Address1: | 224 COLUMBUS RD | ||||||||
| Address2: | |||||||||
| City: | ATHENS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 457011334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405926724 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2018 | ||||||||
| LastUpdateDate: | 09/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN.288726 | OH | N | Nursing Service Providers | Registered Nurse | 101YM0800X | C2103270 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.