Provider Demographics
NPI:1225180219
Name:FAY, SHERI (LMFT, LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:
Last Name:FAY
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2128
Mailing Address - Country:US
Mailing Address - Phone:484-270-8920
Mailing Address - Fax:
Practice Address - Street 1:31 N NARBERTH AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2347
Practice Address - Country:US
Practice Address - Phone:267-872-5033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003490101YP2500X
PAMF000410106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA20-5542374OtherTAX ID