Provider Demographics
NPI:1912398041
Name:CONSTANT, SHERLY (LCSW,CAP)
Entity Type:Individual
Prefix:
First Name:SHERLY
Middle Name:
Last Name:CONSTANT
Suffix:
Gender:F
Credentials:LCSW,CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1731
Mailing Address - Country:US
Mailing Address - Phone:954-661-4032
Mailing Address - Fax:
Practice Address - Street 1:9350 NW 21ST MNR
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-3750
Practice Address - Country:US
Practice Address - Phone:954-661-4032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW9457101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health