Provider Demographics
NPI:1962800094
Name:STINSON, SHERRI (LCSW)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:STINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:ALLARDT
Mailing Address - State:TN
Mailing Address - Zip Code:38504-0026
Mailing Address - Country:US
Mailing Address - Phone:931-879-7198
Mailing Address - Fax:
Practice Address - Street 1:2000 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:ALLARDT
Practice Address - State:TN
Practice Address - Zip Code:38504-0026
Practice Address - Country:US
Practice Address - Phone:931-879-7198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN58971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5897OtherLCSW