Provider Demographics
NPI:1447788062
Name:SHERD, LINDSEY (PHD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:SHERD
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 RAYBROOK ST SE STE 201-B
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7739
Mailing Address - Country:US
Mailing Address - Phone:616-320-4689
Mailing Address - Fax:616-369-5750
Practice Address - Street 1:2040 RAYBROOK ST SE STE 201-B
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7739
Practice Address - Country:US
Practice Address - Phone:616-320-4689
Practice Address - Fax:616-369-5750
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301018042103T00000X, 103TC1900X, 103TC0700X
MI6301017081103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI12345OtherAUTHENTIC CONNECTION PSYCHOLOGICAL SERVICES, LLC