Provider Demographics
NPI:1861531402
Name:MARTIN, SHERRY DEAN (LPC)
Entity type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:DEAN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:SHERRY
Other - Middle Name:DEAN
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:6801 S WESTERN AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-1816
Mailing Address - Country:US
Mailing Address - Phone:405-600-1042
Mailing Address - Fax:405-600-1052
Practice Address - Street 1:6801 S WESTERN AVE STE 206
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1816
Practice Address - Country:US
Practice Address - Phone:405-600-1042
Practice Address - Fax:405-600-1052
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2707101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional