Provider Demographics
NPI:1750490488
Name:SHERWOOD, SHIRLEY Y (LCSW AAC)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:Y
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:LCSW AAC
Other - Prefix:MISS
Other - First Name:SHIRLEY
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, ACP, CCDS
Mailing Address - Street 1:902 CRYSTAL FALLS PKWY
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-3646
Mailing Address - Country:US
Mailing Address - Phone:512-421-4023
Mailing Address - Fax:512-259-2290
Practice Address - Street 1:902 CRYSTAL FALLS PKWY
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-3646
Practice Address - Country:US
Practice Address - Phone:512-421-4023
Practice Address - Fax:512-259-2290
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX505976104100000X
TX10620800101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0088CTOtherBCBS
TX0088CTOtherBCBS