Provider Demographics
NPI:1972952489
Name:CARTER-GREENE, SHERRIE LYNN (LP C (CANDIDATE))
Entity type:Individual
Prefix:MS
First Name:SHERRIE
Middle Name:LYNN
Last Name:CARTER-GREENE
Suffix:
Gender:F
Credentials:LP C (CANDIDATE)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8250 CONIFER RD
Mailing Address - Street 2:
Mailing Address - City:HENRYETTA
Mailing Address - State:OK
Mailing Address - Zip Code:74437-1465
Mailing Address - Country:US
Mailing Address - Phone:918-557-6882
Mailing Address - Fax:918-794-9622
Practice Address - Street 1:130 N GREENWOOD AVE
Practice Address - Street 2:STE 305
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-1443
Practice Address - Country:US
Practice Address - Phone:918-557-6882
Practice Address - Fax:918-794-3636
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst