Provider Demographics
NPI:1396875407
Name:OSBORN, SHERYL (LPCC,LPC,CCAC)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:OSBORN
Suffix:
Gender:F
Credentials:LPCC,LPC,CCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 MISSION DR
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-5561
Mailing Address - Country:US
Mailing Address - Phone:304-485-1781
Mailing Address - Fax:304-485-1782
Practice Address - Street 1:1011 MISSION DR
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-5561
Practice Address - Country:US
Practice Address - Phone:304-485-1781
Practice Address - Fax:304-485-1782
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1332101Y00000X
OHE1852101Y00000X
WV99-305101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)