Provider Demographics
NPI:1437451051
Name:SAGET-MENAGER, SHERLEY
Entity Type:Individual
Prefix:
First Name:SHERLEY
Middle Name:
Last Name:SAGET-MENAGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 S BROADWAY STE 7
Mailing Address - Street 2:
Mailing Address - City:PITMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08071-2235
Mailing Address - Country:US
Mailing Address - Phone:844-365-7676
Mailing Address - Fax:
Practice Address - Street 1:901 ROUTE 168
Practice Address - Street 2:SUITE 404A
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-3210
Practice Address - Country:US
Practice Address - Phone:610-644-6464
Practice Address - Fax:856-288-5139
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00549100103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical