Provider Demographics
NPI:1992923312
Name:LEWIS, SHERRY LYNN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:LYNN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:SHERRY
Other - Middle Name:LYNN
Other - Last Name:NYQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:49774 ROAD 426, SUITE D
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:CA
Mailing Address - Zip Code:93644
Mailing Address - Country:US
Mailing Address - Phone:559-683-4809
Mailing Address - Fax:559-683-6499
Practice Address - Street 1:49774 ROAD 426, SUITE D
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644
Practice Address - Country:US
Practice Address - Phone:559-683-4809
Practice Address - Fax:559-683-6499
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA242751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical