Provider Demographics
NPI:1871901611
Name:WILLIAMS-PELT, SHERIDAN LASHELL (ASSOCIATE DEGREE)
Entity type:Individual
Prefix:MRS
First Name:SHERIDAN
Middle Name:LASHELL
Last Name:WILLIAMS-PELT
Suffix:
Gender:F
Credentials:ASSOCIATE DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 312087
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48231
Mailing Address - Country:US
Mailing Address - Phone:313-993-4700
Mailing Address - Fax:313-831-2299
Practice Address - Street 1:19211 ANGLIN
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234
Practice Address - Country:US
Practice Address - Phone:313-263-0077
Practice Address - Fax:313-305-5007
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor