Provider Demographics
NPI:1063529238
Name:IRELAND, SHERYL JANE (LPC)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:JANE
Last Name:IRELAND
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 1:7320 SW HUNZIKER ST
Mailing Address - Street 2:# 306
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223
Mailing Address - Country:US
Mailing Address - Phone:503-620-1500
Mailing Address - Fax:503-620-1504
Practice Address - Street 1:7320 SW HUNZIKER ST
Practice Address - Street 2:# 306
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223
Practice Address - Country:US
Practice Address - Phone:503-620-1500
Practice Address - Fax:503-620-1504
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional