Provider Demographics
NPI:1760853345
Name:TYDINGS, SHERYL (LGSW)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:TYDINGS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4129 BRUSHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-7353
Mailing Address - Country:US
Mailing Address - Phone:240-818-6530
Mailing Address - Fax:
Practice Address - Street 1:4129 BRUSHFIELD DR
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-7353
Practice Address - Country:US
Practice Address - Phone:240-818-6530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD189961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical