Provider Demographics
NPI:1497148522
Name:SHERRY HENDERSON MSW LLC
Entity Type:Organization
Organization Name:SHERRY HENDERSON MSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:206-652-1278
Mailing Address - Street 1:911 WESTERN AVE
Mailing Address - Street 2:399
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3605
Mailing Address - Country:US
Mailing Address - Phone:206-652-1278
Mailing Address - Fax:206-621-7127
Practice Address - Street 1:911 WESTERN AVE
Practice Address - Street 2:399
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3605
Practice Address - Country:US
Practice Address - Phone:206-652-1278
Practice Address - Fax:206-621-7127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000052751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty