Provider Demographics
NPI:1962618280
Name:CORYELL, SHERYL ANN (LMFT)
Entity type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:ANN
Last Name:CORYELL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 BERKELEY WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1007
Mailing Address - Country:US
Mailing Address - Phone:510-918-2100
Mailing Address - Fax:
Practice Address - Street 1:1903 BERKELEY WAY STE 2
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1007
Practice Address - Country:US
Practice Address - Phone:510-918-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35535106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist