Provider Demographics
NPI:1669502936
Name:SHERRY, STEVEN ERIC (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:ERIC
Last Name:SHERRY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 AIRPORT WAY
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-8500
Mailing Address - Country:US
Mailing Address - Phone:805-288-4420
Mailing Address - Fax:
Practice Address - Street 1:500 AIRPORT WAY
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-8500
Practice Address - Country:US
Practice Address - Phone:805-288-4420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 20944171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator