Provider Demographics
NPI:1679800015
Name:SHERWIN, SCOTT ALAN (MSCM)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALAN
Last Name:SHERWIN
Suffix:
Gender:M
Credentials:MSCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3222
Mailing Address - Country:US
Mailing Address - Phone:678-721-5922
Mailing Address - Fax:
Practice Address - Street 1:20 DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3222
Practice Address - Country:US
Practice Address - Phone:678-721-5922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst