Provider Demographics
NPI:1689029183
Name:SHERRY, AMANDA (LPCC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:SHERRY
Suffix:
Gender:
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6591 W CENTRAL AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1097
Mailing Address - Country:US
Mailing Address - Phone:419-930-9700
Mailing Address - Fax:419-540-8835
Practice Address - Street 1:6591 W CENTRAL AVE STE 103
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1097
Practice Address - Country:US
Practice Address - Phone:419-930-9700
Practice Address - Fax:419-540-8835
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1700455101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health