Provider Demographics
NPI:1316724446
Name:CLEMENT, SHERRI L (LMSW)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:L
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SHERI
Other - Middle Name:L
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:13744 WHITMAN RD.
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833
Mailing Address - Country:US
Mailing Address - Phone:858-442-2870
Mailing Address - Fax:
Practice Address - Street 1:13744 WHITMAN RD.
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833
Practice Address - Country:US
Practice Address - Phone:979-353-1137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111198101YM0800X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1164011292Medicaid