Provider Demographics
NPI:1063978815
Name:VLAHAKIS, SHERRIE L (LSC)
Entity type:Individual
Prefix:MS
First Name:SHERRIE
Middle Name:L
Last Name:VLAHAKIS
Suffix:
Gender:F
Credentials:LSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 COURTHOUSE LN UNIT 3
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1716
Mailing Address - Country:US
Mailing Address - Phone:978-275-9444
Mailing Address - Fax:
Practice Address - Street 1:2 COURTHOUSE LANE SUITE # 3
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-0182
Practice Address - Country:US
Practice Address - Phone:978-275-9444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA332726101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA332726OtherBILLING PROVIDER