Healthcare Provider Details

I. General information

NPI: 1215578844
Provider Name (Legal Business Name): SHERRINA SCOTT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2019
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N17W24222 RIVERWOOD DR STE 170
WAUKESHA WI
53188-1134
US

IV. Provider business mailing address

N17W24222 RIVERWOOD DR STE 170
WAUKESHA WI
53188-1134
US

V. Phone/Fax

Practice location:
  • Phone: 262-999-3495
  • Fax:
Mailing address:
  • Phone: 757-478-4776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11092-115
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: