Provider Demographics
NPI:1710383112
Name:MCPHERSON-BERG, SHERRY L (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:L
Last Name:MCPHERSON-BERG
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 BUFFALO AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD,
Mailing Address - State:NY
Mailing Address - Zip Code:11763
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:181 BUFFALO AVENUE
Practice Address - Street 2:
Practice Address - City:MEDFORD,
Practice Address - State:NY
Practice Address - Zip Code:11763
Practice Address - Country:US
Practice Address - Phone:631-687-6579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0538171041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool