Provider Demographics
NPI:1508400466
Name:AUGUSTIN, SHERIE (LCSW)
Entity Type:Individual
Prefix:
First Name:SHERIE
Middle Name:
Last Name:AUGUSTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 WOODPORT RD STE D
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-2610
Mailing Address - Country:US
Mailing Address - Phone:973-691-3030
Mailing Address - Fax:
Practice Address - Street 1:172 WOODPORT RD STE D
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-2610
Practice Address - Country:US
Practice Address - Phone:973-691-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058937001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical