Healthcare Provider Details

I. General information

NPI: 1396536702
Provider Name (Legal Business Name): MELISSA SHERRY PHD, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 01/11/2026
Certification Date: 01/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 JOHNSTOWN CENTER DR UNIT 211
JOHNSTOWN CO
80534-7848
US

IV. Provider business mailing address

257 JOHNSTOWN CENTER DR UNIT 211
JOHNSTOWN CO
80534-7848
US

V. Phone/Fax

Practice location:
  • Phone: 970-306-6144
  • Fax:
Mailing address:
  • Phone: 970-306-6144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY.0006730
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY-005942
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: