Provider Demographics
NPI:1760849459
Name:MACALUSO, SHERRY (LPC, LPES)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:
Last Name:MACALUSO
Suffix:
Gender:F
Credentials:LPC, LPES
Other - Prefix:MRS
Other - First Name:SHERRY
Other - Middle Name:WILDEBOER
Other - Last Name:MACALUSO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, LPES
Mailing Address - Street 1:2008 OLD BIRCH DRIVE
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016
Mailing Address - Country:US
Mailing Address - Phone:803-735-1497
Mailing Address - Fax:
Practice Address - Street 1:2008 OLD BIRCH DRIVE
Practice Address - Street 2:
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016
Practice Address - Country:US
Practice Address - Phone:803-735-1497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2537101YP2500X
SC3067103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling