Provider Demographics
NPI:1659780815
Name:EDELMAN, SHERRI (PSYD)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:EDELMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 WASHINGTON AVE UNIT 509
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3850
Mailing Address - Country:US
Mailing Address - Phone:215-990-7374
Mailing Address - Fax:215-755-4013
Practice Address - Street 1:1101 WASHINGTON AVE UNIT 509
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-3850
Practice Address - Country:US
Practice Address - Phone:215-990-7374
Practice Address - Fax:215-755-4013
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002795101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional