Provider Demographics
NPI:1235446733
Name:GANSZ, SHERRI (LCSW)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:GANSZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 903
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:AR
Mailing Address - Zip Code:72730-0903
Mailing Address - Country:US
Mailing Address - Phone:479-267-6934
Mailing Address - Fax:667-983-3458
Practice Address - Street 1:128 SOUTHWINDS RD STE 5
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:AR
Practice Address - Zip Code:72730-8678
Practice Address - Country:US
Practice Address - Phone:479-267-6934
Practice Address - Fax:866-798-3345
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
AR2588-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker