Provider Demographics
NPI:1861055444
Name:SHERMAN, WYNNE LOUISE (LCDC, LPC-I)
Entity type:Individual
Prefix:
First Name:WYNNE
Middle Name:LOUISE
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:LCDC, LPC-I
Other - Prefix:
Other - First Name:WYNNE
Other - Middle Name:LOUISE
Other - Last Name:KIKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCDC, LPC-I
Mailing Address - Street 1:1917 RIDGEMORE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-1407
Mailing Address - Country:US
Mailing Address - Phone:469-352-6091
Mailing Address - Fax:
Practice Address - Street 1:5757 WOODWAY DR STE 110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-1506
Practice Address - Country:US
Practice Address - Phone:469-352-6091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81228101YM0800X
TX12281101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health