Provider Demographics
NPI:1932322401
Name:SHERER-VINCENT, SUSAN ANN (LCSW, LMFT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANN
Last Name:SHERER-VINCENT
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-2329
Mailing Address - Country:US
Mailing Address - Phone:317-776-8990
Mailing Address - Fax:317-776-0404
Practice Address - Street 1:1036 CLINTON ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2329
Practice Address - Country:US
Practice Address - Phone:317-776-8990
Practice Address - Fax:317-776-0404
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34001991A104100000X
IN35001109A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist