Provider Demographics
NPI:1902228588
Name:MERRIAM, SHERRY LM (MA, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:LM
Last Name:MERRIAM
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:MRS
Other - First Name:SHERRY
Other - Middle Name:LYNN
Other - Last Name:MERRIAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LPCC
Mailing Address - Street 1:PO BOX 5652
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-0491
Mailing Address - Country:US
Mailing Address - Phone:952-210-4082
Mailing Address - Fax:
Practice Address - Street 1:2809 WAYZATA BLVD
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-2125
Practice Address - Country:US
Practice Address - Phone:612-377-9190
Practice Address - Fax:612-374-4498
Is Sole Proprietor?:No
Enumeration Date:2014-01-15
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN974101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional