Provider Demographics
NPI:1558567842
Name:ROTEM, SHERRY (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:
Last Name:ROTEM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CECILIA CT
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-1458
Mailing Address - Country:US
Mailing Address - Phone:732-961-7158
Mailing Address - Fax:
Practice Address - Street 1:12 CECILIA CT
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-1458
Practice Address - Country:US
Practice Address - Phone:732-961-7158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000606106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist