Provider Demographics
NPI:1154504777
Name:LEBEZNICK BROWN, SHERRY LYNN (MSW)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:LYNN
Last Name:LEBEZNICK BROWN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 GRIEGOS RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-3752
Mailing Address - Country:US
Mailing Address - Phone:505-832-9322
Mailing Address - Fax:505-832-9326
Practice Address - Street 1:8 CASEY CT
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:NM
Practice Address - Zip Code:87015-7120
Practice Address - Country:US
Practice Address - Phone:505-730-6735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-077301041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical