Provider Demographics
NPI:1043429194
Name:VAVRICHEK, SHERRIE MANSFIELD (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:SHERRIE
Middle Name:MANSFIELD
Last Name:VAVRICHEK
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 COBBLESTONE CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-5806
Mailing Address - Country:US
Mailing Address - Phone:301-989-1399
Mailing Address - Fax:
Practice Address - Street 1:11227 LOCKWOOD DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4562
Practice Address - Country:US
Practice Address - Phone:301-593-4040
Practice Address - Fax:301-593-9148
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD027701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDVA483745Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER