Provider Demographics
NPI:1588839047
Name:D'ELIA, SHERRY MINNITI (LCSW)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:MINNITI
Last Name:D'ELIA
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 1:17 OLD KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4522
Mailing Address - Country:US
Mailing Address - Phone:203-655-4854
Mailing Address - Fax:203-373-9607
Practice Address - Street 1:17 OLD KINGS HWY S
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4522
Practice Address - Country:US
Practice Address - Phone:203-655-4854
Practice Address - Fax:203-373-9607
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0042811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT800002264Medicare PIN