Healthcare Provider Details

I. General information

NPI: 1942776349
Provider Name (Legal Business Name): SHERYL DENISE ARMSTRONG M.A., M.DIV
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 LEISURE LAKE DR # Y9
WARNER ROBINS GA
31088-7360
US

IV. Provider business mailing address

800 LEISURE LAKE DR # Y9
WARNER ROBINS GA
31088-7360
US

V. Phone/Fax

Practice location:
  • Phone: 478-449-0167
  • Fax:
Mailing address:
  • Phone: 478-449-0167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number63205
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number63205
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: