Provider Demographics
NPI:1255485397
Name:POWER, SHERYL LYNN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:LYNN
Last Name:POWER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:SHERYL
Other - Middle Name:LYNN
Other - Last Name:DOWNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:412 DEPOT ROAD
Mailing Address - Street 2:
Mailing Address - City:TAMWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03886-4405
Mailing Address - Country:US
Mailing Address - Phone:603-651-8182
Mailing Address - Fax:
Practice Address - Street 1:448 WHITE MOUNTAIN HIGHWAY
Practice Address - Street 2:
Practice Address - City:TAMWORTH
Practice Address - State:NH
Practice Address - Zip Code:03886-4405
Practice Address - Country:US
Practice Address - Phone:603-651-8182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1244104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30423327Medicaid
NH14Y008119NH01OtherANTHEM BC NH
NH30423327Medicaid