Provider Demographics
NPI:1982054540
Name:BASSEWITZ, SHERI Z (LCSW)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:Z
Last Name:BASSEWITZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WESTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-4025
Mailing Address - Country:US
Mailing Address - Phone:847-421-9024
Mailing Address - Fax:847-267-9025
Practice Address - Street 1:8 WESTWOOD LN
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-4025
Practice Address - Country:US
Practice Address - Phone:847-421-9024
Practice Address - Fax:847-267-9025
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490070851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical