Provider Demographics
NPI:1194142729
Name:OBERLIN, SHERILYN MARIE (LLPC)
Entity type:Individual
Prefix:MRS
First Name:SHERILYN
Middle Name:MARIE
Last Name:OBERLIN
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 S DON ROSER DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4550
Mailing Address - Country:US
Mailing Address - Phone:575-636-2506
Mailing Address - Fax:
Practice Address - Street 1:1635 S DON ROSER DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4550
Practice Address - Country:US
Practice Address - Phone:575-636-2506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0180421101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM34722751Medicaid
NM850422820Medicare UPIN