Provider Demographics
NPI:1104562966
Name:WEXLER, SHERRY ILYSE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:ILYSE
Last Name:WEXLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:SACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:667 E BIG BEAVER RD STE 107
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1430
Mailing Address - Country:US
Mailing Address - Phone:248-250-6620
Mailing Address - Fax:
Practice Address - Street 1:667 E BIG BEAVER RD SUITE 107
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1429
Practice Address - Country:US
Practice Address - Phone:248-250-6620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010589641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical