Provider Demographics
NPI:1063408060
Name:BELLMAN, SHERYL (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:
Last Name:BELLMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SHERYL
Other - Middle Name:
Other - Last Name:BELLMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1778 SW 81ST WAY
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4608
Mailing Address - Country:US
Mailing Address - Phone:954-424-3613
Mailing Address - Fax:954-441-8864
Practice Address - Street 1:4801 S UNIVERSITY DR
Practice Address - Street 2:SUITE 205
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3839
Practice Address - Country:US
Practice Address - Phone:954-424-3613
Practice Address - Fax:954-441-8864
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW0002917101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ4689Medicare ID - Type UnspecifiedMEDICARE I.D