Provider Demographics
NPI:1831321397
Name:FREDERICK, MARGUERITE SHERWIN (LISW)
Entity Type:Individual
Prefix:MRS
First Name:MARGUERITE
Middle Name:SHERWIN
Last Name:FREDERICK
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MS
Other - First Name:MARGUERITE
Other - Middle Name:
Other - Last Name:SHERWIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW
Mailing Address - Street 1:71 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-4234
Mailing Address - Country:US
Mailing Address - Phone:440-346-4101
Mailing Address - Fax:
Practice Address - Street 1:11900 FAIRHILL RD.
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1053
Practice Address - Country:US
Practice Address - Phone:216-791-8000
Practice Address - Fax:121-637-3181
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI09000501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical