Provider Demographics
NPI:1972694867
Name:ZITTER, SHERRY M (MSW, LISCW, BCD)
Entity type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:M
Last Name:ZITTER
Suffix:
Gender:F
Credentials:MSW, LISCW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:MA
Mailing Address - Zip Code:01754-1345
Mailing Address - Country:US
Mailing Address - Phone:978-562-1801
Mailing Address - Fax:978-562-1801
Practice Address - Street 1:45 LYMAN ST STE 19
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2658
Practice Address - Country:US
Practice Address - Phone:508-366-8576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1060601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA063033000OtherMAGELLAN PROVIDER NUMBER
MA0433895770000OtherCIGNA PROVIDER NUMBER
MA726778OtherTUFTS PROVIDER NUMBER
MAP04932OtherBCBS PROVIDER NUMBER
MA1859994Medicaid
MA1859994Medicaid