Provider Demographics
NPI:1063756971
Name:SMITH, SHERRY TONIE (LLMSW)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:TONIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38855 HILLS TECH DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-3421
Mailing Address - Country:US
Mailing Address - Phone:248-745-4900
Mailing Address - Fax:248-745-6972
Practice Address - Street 1:38855 HILLS TECH DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3421
Practice Address - Country:US
Practice Address - Phone:248-745-4900
Practice Address - Fax:248-745-6972
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010929231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical