Provider Demographics
NPI:1518486000
Name:BALDWIN, SHERRY RENEE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:RENEE
Last Name:BALDWIN
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 1:3427 CREEKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-5039
Mailing Address - Country:US
Mailing Address - Phone:678-612-9140
Mailing Address - Fax:
Practice Address - Street 1:424 DECATUR ST SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1848
Practice Address - Country:US
Practice Address - Phone:678-843-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-15
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW007419104100000X
GACSW0071591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker