Provider Demographics
NPI:1578869780
Name:WEISTANER, SHERI STARBIRD (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHERI
Middle Name:STARBIRD
Last Name:WEISTANER
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 1:602 E GARDEN AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2945
Mailing Address - Country:US
Mailing Address - Phone:208-661-3864
Mailing Address - Fax:208-981-0005
Practice Address - Street 1:602 E GARDEN AVE STE 5
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2945
Practice Address - Country:US
Practice Address - Phone:208-661-3864
Practice Address - Fax:208-981-0005
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-04
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-322891041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical