Provider Demographics
NPI:1861932709
Name:WATERMAN, SHERYN (PHD)
Entity type:Individual
Prefix:DR
First Name:SHERYN
Middle Name:
Last Name:WATERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 BEAUFAIN CT
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-6168
Mailing Address - Country:US
Mailing Address - Phone:919-943-2222
Mailing Address - Fax:
Practice Address - Street 1:153 BEAUFAIN CT
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-6168
Practice Address - Country:US
Practice Address - Phone:919-943-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-25
Last Update Date:2017-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5414101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional