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General NPI Number Information
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NPI Number | 1790389534
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Entity Type | Individual
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Provider Name | SHERRY-ANN MARIE STREETE FORD LSATP, LPC
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Gender | Female
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 1811 KING ST
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City | PORTSMOUTH
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State | VA
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Zip | 23704-3032
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Country | US
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Telephone | 757-393-8618
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Fax | 757-393-5074
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Provider Business Mailing Address
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Address Line | 540 E BUTE ST
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City | NORFOLK
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State | VA
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Zip | 23510-2804
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Country | US
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Telephone | 757-461-4141
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Fax | 757-962-7251
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0718000397
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0710102685
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701008833
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License Number State | VA
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