Provider Demographics
NPI:1891008645
Name:QUARLESS, SHERLON (LMSW-CASAC)
Entity Type:Individual
Prefix:MS
First Name:SHERLON
Middle Name:
Last Name:QUARLESS
Suffix:
Gender:F
Credentials:LMSW-CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-3402
Mailing Address - Country:US
Mailing Address - Phone:914-964-8005
Mailing Address - Fax:914-964-8038
Practice Address - Street 1:2 PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-3402
Practice Address - Country:US
Practice Address - Phone:914-964-8005
Practice Address - Fax:914-964-8038
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NY099246104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)