Healthcare Provider Details

I. General information

NPI: 1114832268
Provider Name (Legal Business Name): TIYI SHERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4234 I 75 BUSINESS SPUR # 227
SAULT SAINTE MARIE MI
49783-3620
US

IV. Provider business mailing address

4234 I 75 BUSINESS SPUR # 227
SAULT SAINTE MARIE MI
49783-3620
US

V. Phone/Fax

Practice location:
  • Phone: 469-254-4706
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801122291
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: