Provider Demographics
NPI:1457442543
Name:BONDER, SHERYN FAITH (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SHERYN
Middle Name:FAITH
Last Name:BONDER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BROAD ST
Mailing Address - Street 2:APT. #2
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-2103
Mailing Address - Country:US
Mailing Address - Phone:978-462-7046
Mailing Address - Fax:978-462-7016
Practice Address - Street 1:30 GREEN ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2650
Practice Address - Country:US
Practice Address - Phone:978-462-7046
Practice Address - Fax:978-462-7016
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASW1020267-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical