Provider Demographics
NPI:1730376005
Name:GAYHEART, SHERRY BELLAR (LISW)
Entity type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:BELLAR
Last Name:GAYHEART
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MS
Other - First Name:SHERRY
Other - Middle Name:M
Other - Last Name:BELLAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISE
Mailing Address - Street 1:PO BOX 1507
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-1507
Mailing Address - Country:US
Mailing Address - Phone:740-354-7702
Mailing Address - Fax:740-353-1662
Practice Address - Street 1:192 CHESTNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693-9584
Practice Address - Country:US
Practice Address - Phone:937-544-3400
Practice Address - Fax:740-353-1662
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYS0031349101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health