Provider Demographics
NPI:1427125608
Name:HUMPHREY-JONES, SHERRY HALE (PHD)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:HALE
Last Name:HUMPHREY-JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3214 CHARING CROSS
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4369
Mailing Address - Country:US
Mailing Address - Phone:302-239-1076
Mailing Address - Fax:302-234-7924
Practice Address - Street 1:5700 KIRKWOOD HWY
Practice Address - Street 2:PARK CENTER, SUITE 104
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4857
Practice Address - Country:US
Practice Address - Phone:302-373-5915
Practice Address - Fax:302-234-7924
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000317101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000025880Medicaid