Provider Demographics
NPI:1154413268
Name:FOWLER, SHERYL A (LCSWR)
Entity type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:A
Last Name:FOWLER
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 FORD AVE
Mailing Address - Street 2:
Mailing Address - City:ROTTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12306-1627
Mailing Address - Country:US
Mailing Address - Phone:518-377-6450
Mailing Address - Fax:
Practice Address - Street 1:1322 GERLING ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-1702
Practice Address - Country:US
Practice Address - Phone:518-346-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR033104-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical