Healthcare Provider Details

I. General information

NPI: 1760394985
Provider Name (Legal Business Name): LESLIE SHERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 2ND ST
LAPEER MI
48446-1445
US

IV. Provider business mailing address

2788 HADLEY RD
LAPEER MI
48446-9743
US

V. Phone/Fax

Practice location:
  • Phone: 810-694-1287
  • Fax:
Mailing address:
  • Phone: 810-694-1287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6851109200
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: