Basic Information
Provider Information
NPI: 1295128361
EntityType: 2
ReplacementNPI:  
OrganizationName: SHERRY A DEES LMSW ACSW LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
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Mailing Information
Address1: 23933 ALLEN RD
Address2: STE. 3
City: WOODHAVEN
State: MI
PostalCode: 481833372
CountryCode: US
TelephoneNumber: 7347190863
FaxNumber: 7342177501
Practice Location
Address1: 23933 ALLEN RD
Address2: STE. 3
City: WOODHAVEN
State: MI
PostalCode: 481833372
CountryCode: US
TelephoneNumber: 7347190863
FaxNumber: 7342177501
Other Information
ProviderEnumerationDate: 03/12/2015
LastUpdateDate: 03/12/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: DEES
AuthorizedOfficialFirstName: SHERRY
AuthorizedOfficialMiddleName: ANN
AuthorizedOfficialTitleorPosition: THERAPIST
AuthorizedOfficialTelephone: 7347190863
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: LMSW
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X5801059374MIY193400000X SINGLE SPECIALTY GROUPBehavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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