Provider Demographics
NPI:1386637932
Name:SHERMAN, MARK A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:A
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2181 S EL CAMINO REAL
Mailing Address - Street 2:SUITE 307
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6288
Mailing Address - Country:US
Mailing Address - Phone:760-721-4500
Mailing Address - Fax:760-512-3113
Practice Address - Street 1:2181 S EL CAMINO REAL STE 307
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6288
Practice Address - Country:US
Practice Address - Phone:760-721-4500
Practice Address - Fax:760-512-3113
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS14106101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW14106Medicare ID - Type Unspecified