Provider Demographics
NPI:1730623810
Name:STORY, SHERI O (LCSW)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:O
Last Name:STORY
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 1:2151 BERKLEY AVE SW
Mailing Address - Street 2:APT 2
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-2007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2151 BERKLEY AVE SW
Practice Address - Street 2:APT 2
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24015-2007
Practice Address - Country:US
Practice Address - Phone:757-633-7823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL63181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical