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Provider Information for 1255704748


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SHERRITA MARIE FORREST


Other Names:  
Professional Name: 
SHERRITA MARIE HARRISON LPC

Sex: Female

NPI: 1255704748
Last Updated: 2024-08-05
Certification Date: 2024-08-05

Details

NameValue
NPI1255704748
Enumeration Date2015-11-05
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1030 JEFFERSON AVE
MEMPHIS, TN 38104-2127
United States

Phone: 901-523-8990 | Fax:
 
Primary Practice Address 1030 JEFFERSON AVE
MEMPHIS, TN 38104-2127
United States

Phone: 901-523-8990 | Fax:
 
Secondary Practice Address(es)

118 E 91ST ST APT 3D
NEW YORK, NY 10128-1696
United States

Phone: 607-362-4471 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YM0800X - Counselor - Mental Health
No 101YP2500X - Counselor - Professional
Yes 101YP2500X - Counselor - ProfessionalTN6786