Provider Demographics
NPI:1366546913
Name:WATSON, SHERYL DUNN (LPC, LMHC, CCMHC)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:DUNN
Last Name:WATSON
Suffix:
Gender:F
Credentials:LPC, LMHC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 S MACADAM AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3970
Mailing Address - Country:US
Mailing Address - Phone:503-684-7948
Mailing Address - Fax:503-715-1830
Practice Address - Street 1:4800 S MACADAM AVE STE 350
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3970
Practice Address - Country:US
Practice Address - Phone:503-684-7948
Practice Address - Fax:503-715-1830
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1097101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health