Provider Demographics
NPI:1689494312
Name:WELCH, SHERAYNE ARIEL
Entity type:Individual
Prefix:
First Name:SHERAYNE
Middle Name:ARIEL
Last Name:WELCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 LAGOON PL APT 406
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-6744
Mailing Address - Country:US
Mailing Address - Phone:954-947-1596
Mailing Address - Fax:
Practice Address - Street 1:9330 LAGOON PL APT 406
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-6744
Practice Address - Country:US
Practice Address - Phone:954-947-1596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23974101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health