Active NPI
Sherri Leigh Park, LPC-A
- Professional Counselor
- Mansfield, TX
National Provider Identifier
1891579769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 65285
- Practice address
- 2363 U.S. 287 Frontage Rd.
Mansfield, TX 76063 - Phone
- (817) 888-4096
- NPI assigned
- Aug 22, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 65285 | TX | Primary |
Addresses
Primary practice location
2363 U.S. 287 Frontage Rd.
Mansfield, TX 76063
Mailing address
833 Voltamp Dr
Fort Worth, TX 76108-4627
Phone (817) 888-4096
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65285 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692662400000",
"number": "1891579769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 VOLTAMP DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761084627",
"telephone_number": "817-888-4096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2363 U.S. 287 FRONTAGE RD.",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "76063",
"telephone_number": "817-888-4096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "SHERRI",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "LPC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-22",
"last_updated": "2023-08-22",
"certification_date": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "65285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.