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General NPI Number Information
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NPI Number | 1962592170
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Entity Type | Individual
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Provider Name | KARLA RAE SHERMAN MCP, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1500 E WOODROW WILSON AVE MH-ADTP/116A4
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City | JACKSON
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State | MS
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Zip | 39216-5116
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Country | US
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Telephone | 601-362-4471
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Fax | 601-364-1386
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Provider Business Mailing Address
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Address Line | 853 ROBINWOOD DR
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City | BYRAM
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State | MS
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Zip | 39272-6054
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Country | US
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Telephone | 601-346-7750
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0782
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License Number State | MS
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