Healthcare Provider Details

I. General information

NPI: 1063430270
Provider Name (Legal Business Name): DEBRA LYNN SHERMAN LPCC, CCDC I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 GRANVILLE ST
GAHANNA OH
43230-2990
US

IV. Provider business mailing address

4292 CLEVELAND AVE
COLUMBUS OH
43224-1676
US

V. Phone/Fax

Practice location:
  • Phone: 614-475-7090
  • Fax: 614-475-5208
Mailing address:
  • Phone: 614-471-5381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE-0002354
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0002354
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberE-0002354
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: