Provider Demographics
NPI:1821364589
Name:VERNICK, SHEILA K (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:K
Last Name:VERNICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 470552
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE VILLAGE
Mailing Address - State:MA
Mailing Address - Zip Code:02447-0552
Mailing Address - Country:US
Mailing Address - Phone:617-930-3023
Mailing Address - Fax:
Practice Address - Street 1:250 HAMMOND POND PKWY.
Practice Address - Street 2:UNIT 1421
Practice Address - City:BROOKLINE VILLAGE
Practice Address - State:MA
Practice Address - Zip Code:02447-0552
Practice Address - Country:US
Practice Address - Phone:617-930-3023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2472103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist