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General NPI Number Information
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NPI Number | 1407290109
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Entity Type | Individual
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Provider Name | LA'CUANA MATRIA SHERMAN LPC
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Gender | Female
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Dates
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Enumeration Date | 04/24/2013
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Last Update Date | 11/21/2018
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Provider Practice Location Address
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Address Line | 8455 HIGHWAY 85 BUILDING 200 SUITE B
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City | RIVERDALE
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State | GA
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Zip | 30274-5115
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Country | US
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Telephone | 678-768-5993
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Fax | 678-868-1111
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Provider Business Mailing Address
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Address Line | 8457 TAYLOR RD
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City | RIVERDALE
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State | GA
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Zip | 30274-4440
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Country | US
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Telephone | 404-644-2970
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Fax | 678-868-1111
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC007272
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License Number State | GA
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