Healthcare Provider Details

I. General information

NPI: 1982828935
Provider Name (Legal Business Name): SHERRY M SUKOL PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 ELLIOTT AVENUE SUITE 3
BRYN MAWR PA
19010-3412
US

IV. Provider business mailing address

33 TREATY DRIVE
WAYNE PA
19087-5510
US

V. Phone/Fax

Practice location:
  • Phone: 610-526-2226
  • Fax:
Mailing address:
  • Phone: 610-640-0423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS003349L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License NumberPS003349L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: