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General NPI Number Information
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NPI Number | 1700087541
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Entity Type | Organization
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Legal Business Name | CAROLINE L SHERRILL PHD PC
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6000 LAKE FORREST DRIVE SUITE 103
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City | ATLANTA
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State | GA
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Zip | 30328
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Country | US
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Telephone | 404-256-9325
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Fax | 404-256-3662
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Provider Business Mailing Address
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Address Line | 6000 LAKE FORREST DRIVE SUITE 103
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City | ATLANTA
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State | GA
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Zip | 30328
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Country | US
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Telephone | 404-256-9325
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Fax | 404-256-3662
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CAROLINE L SHERRILL
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Credential | PHD
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Telephone | 404-256-9325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 2112
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License Number State | GA
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