Provider Demographics
NPI:1245589134
Name:CHEN, SHERRY (LCSW)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7158 AUSTIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4788
Mailing Address - Country:US
Mailing Address - Phone:347-657-5424
Mailing Address - Fax:
Practice Address - Street 1:7158 AUSTIN ST STE 101
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4788
Practice Address - Country:US
Practice Address - Phone:347-657-5424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 171M00000X
NY0866821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator