Provider Demographics
NPI:1902057722
Name:WELCH, SHERRY (PHD LPV)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:PHD LPV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W 31ST ST
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-2442
Mailing Address - Country:US
Mailing Address - Phone:307-634-6883
Mailing Address - Fax:307-634-9462
Practice Address - Street 1:1001 W 31ST ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-2442
Practice Address - Country:US
Practice Address - Phone:307-634-6883
Practice Address - Fax:307-634-9462
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-105101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health