Provider Demographics
NPI:1497971238
Name:RICKSON, SHERI LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHERI
Middle Name:LYNN
Last Name:RICKSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:333 LAFAYETTE AVE
Mailing Address - Street 2:7H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1350
Mailing Address - Country:US
Mailing Address - Phone:718-638-7528
Mailing Address - Fax:718-623-3003
Practice Address - Street 1:29 5TH AVE
Practice Address - Street 2:1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4337
Practice Address - Country:US
Practice Address - Phone:718-623-3366
Practice Address - Fax:718-623-3003
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072508-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical