Provider Demographics
NPI:1114119013
Name:JERIMIE, SHERRY M (LCSW)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:M
Last Name:JERIMIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 LAFAYETTE ST
Mailing Address - Street 2:FLOOR 2 SUITE 8
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6933
Mailing Address - Country:US
Mailing Address - Phone:212-714-4614
Mailing Address - Fax:
Practice Address - Street 1:380 LAFAYETTE ST
Practice Address - Street 2:FLOOR 2 SUITE 8
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6933
Practice Address - Country:US
Practice Address - Phone:212-714-4614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0695451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical