Provider Demographics
NPI:1861791980
Name:NEWPOL, SHERRI LYNN (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHERRI
Middle Name:LYNN
Last Name:NEWPOL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4036 DAUNTLESS LANE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412
Mailing Address - Country:US
Mailing Address - Phone:734-355-8216
Mailing Address - Fax:
Practice Address - Street 1:2301 PACKARD ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6321
Practice Address - Country:US
Practice Address - Phone:734-355-8216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6065103T00000X
MI6301012502103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI6698001OtherMEDICARE INDIVIDUAL PTAN
MIMI6698001Medicare UPIN