Provider Demographics
NPI:1578972071
Name:RESPASS, SHERRIE LISETTE (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:SHERRIE
Middle Name:LISETTE
Last Name:RESPASS
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 ROUTE 70
Mailing Address - Street 2:SUITE 22N
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5900
Mailing Address - Country:US
Mailing Address - Phone:908-607-6364
Mailing Address - Fax:732-905-0329
Practice Address - Street 1:1255 ROUTE 70
Practice Address - Street 2:SUITE 22N
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5900
Practice Address - Country:US
Practice Address - Phone:908-607-6364
Practice Address - Fax:732-905-0329
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05791400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker