Provider Demographics
NPI:1225174675
Name:SHERWOOD, LAURIE BINGHAM (MSSA (MSW))
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:BINGHAM
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:MSSA (MSW)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1836
Mailing Address - Country:US
Mailing Address - Phone:781-559-8107
Mailing Address - Fax:
Practice Address - Street 1:23 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-1836
Practice Address - Country:US
Practice Address - Phone:781-559-8107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1010091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical