Provider Demographics
NPI:1447467105
Name:PATTON-GRUBB, SHERRI DIANE (LPC)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:DIANE
Last Name:PATTON-GRUBB
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13159 HUMPHREY DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-7491
Mailing Address - Country:US
Mailing Address - Phone:512-680-1919
Mailing Address - Fax:
Practice Address - Street 1:13159 HUMPHREY DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-7491
Practice Address - Country:US
Practice Address - Phone:512-680-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12613101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional