Healthcare Provider Details

I. General information

NPI: 1982634168
Provider Name (Legal Business Name): SHERRY DONEY PMHCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 12/11/2021
Certification Date: 12/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9890 CLAYTON RD STE 100
SAINT LOUIS MO
63124-1685
US

IV. Provider business mailing address

38 HICKORY HILL DR
O FALLON MO
63366-1948
US

V. Phone/Fax

Practice location:
  • Phone: 314-725-1515
  • Fax:
Mailing address:
  • Phone: 314-583-0361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number129774
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: