Provider Demographics
NPI:1407894967
Name:SHERMAN, BROOKE A (MA, ED, LPCC-S)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:A
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:MA, ED, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6140 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-3891
Mailing Address - Country:US
Mailing Address - Phone:440-233-7232
Mailing Address - Fax:440-204-4315
Practice Address - Street 1:6140 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-3821
Practice Address - Country:US
Practice Address - Phone:440-233-7232
Practice Address - Fax:440-204-4315
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0003921-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000375668OtherANTHEM PIN NUMBER
OH553309000OtherMAGELLAN MIS NUMBER