Provider Demographics
NPI:1114081437
Name:KING, SHERRI ANN (LSW-CONDITIONAL)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:ANN
Last Name:KING
Suffix:
Gender:F
Credentials:LSW-CONDITIONAL
Other - Prefix:MS
Other - First Name:SHERRI
Other - Middle Name:ANN
Other - Last Name:MCCUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW- CONDITIONAL
Mailing Address - Street 1:67 EUSTIS PARKWAY
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5173
Mailing Address - Country:US
Mailing Address - Phone:207-873-2136
Mailing Address - Fax:
Practice Address - Street 1:67 EUSTIS PKWY
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5173
Practice Address - Country:US
Practice Address - Phone:207-873-2136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker