Provider Demographics
NPI:1689036360
Name:SHERRI H. RAWSTHORN, L.C.S.W., PC
Entity Type:Organization
Organization Name:SHERRI H. RAWSTHORN, L.C.S.W., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:HAYES
Authorized Official - Last Name:RAWSTHORN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-377-6992
Mailing Address - Street 1:440 S PERRY ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4873
Mailing Address - Country:US
Mailing Address - Phone:678-377-6992
Mailing Address - Fax:678-377-6992
Practice Address - Street 1:440 S PERRY ST
Practice Address - Street 2:SUITE 3
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4873
Practice Address - Country:US
Practice Address - Phone:678-377-6992
Practice Address - Fax:678-377-6992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0028831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1457411530OtherINDIVIUAL NPI