Provider Demographics
NPI:1114113917
Name:MCINNIS, SHERRI R (LICSW)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:R
Last Name:MCINNIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MEETING HOUSE ROAD
Mailing Address - Street 2:SUITE 30
Mailing Address - City:CHELSMFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-2742
Mailing Address - Country:US
Mailing Address - Phone:781-956-1709
Mailing Address - Fax:978-616-9942
Practice Address - Street 1:3 MEETING HOUSE ROAD
Practice Address - Street 2:SUITE 30
Practice Address - City:CHELSMFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2742
Practice Address - Country:US
Practice Address - Phone:781-956-1709
Practice Address - Fax:978-616-9942
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-15
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213917104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker