Sheryl Truluck East, LMSW

Individual provider Active NPI Counselor · Lakeland, GA

NPI 1609409705 · NPPES record last updated Feb 17, 2020

Key facts

NPI
1609409705
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
80 Cypress TRL
Lakeland, GA 31635-5433
Phone
(229) 412-3127
Fax
(229) 482-9653
NPI assigned
Feb 17, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Yes

Addresses

Primary practice location

80 Cypress TRL
Lakeland, GA 31635-5433

Mailing address

80 Cypress Trail
Lakeland, GA 31635-4355
Phone (229) 412-3127

Other identifiers

IdentifierTypeStateIssuer
MSW003355OtherGALICENSING BOARD OF PSYCHOLOGIST, SOCIAL WORKERS

Other providers in Lakeland, GA

All providers in Lakeland, GA · Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.