Provider Demographics
NPI:1265392716
Name:WELCH, SHERRY (MA, LMHC)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 SYKES CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-3025
Mailing Address - Country:US
Mailing Address - Phone:407-760-6939
Mailing Address - Fax:
Practice Address - Street 1:4195 US HIGHWAY 1 STE 102
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5385
Practice Address - Country:US
Practice Address - Phone:407-760-6939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22580101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health