Provider Demographics
NPI:1033454061
Name:HALUCHA, SHERRI LYNN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:LYNN
Last Name:HALUCHA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:LYNN
Other - Last Name:ANDERSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-2614
Mailing Address - Country:US
Mailing Address - Phone:631-276-5271
Mailing Address - Fax:631-728-5369
Practice Address - Street 1:17 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-2614
Practice Address - Country:US
Practice Address - Phone:631-276-5271
Practice Address - Fax:631-728-5369
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37604106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist