NPI Code Details Logo

NPI 1619413176

NPI 1619413176 : DAWN SHERROD MSW, CRAADC : SAINT LOUIS, MO

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1619413176
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    DAWN SHERROD MSW, CRAADC
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/09/2017
-----------------------------------------------------
    Last Update Date     |    01/09/2017
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    4130 LINDELL BLVD 
-----------------------------------------------------
    City                 |    SAINT LOUIS
-----------------------------------------------------
    State                |    MO
-----------------------------------------------------
    Zip                  |    63108-2914
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    314-535-5600
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    4049A BOTANICAL AVE 
-----------------------------------------------------
    City                 |    SAINT LOUIS
-----------------------------------------------------
    State                |    MO
-----------------------------------------------------
    Zip                  |    63110-3905
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    314-308-6278
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    101YA0400X
-----------------------------------------------------
    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    MO
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.