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General NPI Number Information
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NPI Number | 1518016617
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Entity Type | Individual
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Provider Name | SHERYLL LYNN PRINZ-MCMILLAN LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 473 E. CARNEGIE DR. SUITE 200
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City | SAN BERNARDINO
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State | CA
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Zip | 92408
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Country | US
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Telephone | 909-312-0607
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Fax |
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Provider Business Mailing Address
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Address Line | 473 E CARNEGIE DR SUITE 200 SAN BERNARDINO CA 92408 SUITE 200
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City | SAN BERNARDINO
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State | CA
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Zip | 92408
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Country | US
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Telephone | 909-312-0607
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFC 32944
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 32944
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License Number State | CA
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