Basic Information
| Provider Information | |||||||||
| NPI: | 1265823041 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHERRY A DEES LMSW ACSW LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23933 ALLEN ROAD | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | WOODHAVEN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347405106 | ||||||||
| FaxNumber: | 7342177501 | ||||||||
| Practice Location | |||||||||
| Address1: | 23933 ALLEN ROAD | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | WOODHAVEN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347405106 | ||||||||
| FaxNumber: | 7342177501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2015 | ||||||||
| LastUpdateDate: | 12/07/2018 | ||||||||
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| AuthorizedOfficialLastName: | DEES | ||||||||
| AuthorizedOfficialFirstName: | SHERRY | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER AND COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 7347405106 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LMSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.