Provider Demographics
NPI:1942381520
Name:VAN HAREN, SHERYL ANN (LCSW, LMFT)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:ANN
Last Name:VAN HAREN
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 1:7635 W BLUEMOUND RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53213-3500
Mailing Address - Country:US
Mailing Address - Phone:414-479-9779
Mailing Address - Fax:414-479-9775
Practice Address - Street 1:7635 W BLUEMOUND RD
Practice Address - Street 2:SUITE 206
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53213-3500
Practice Address - Country:US
Practice Address - Phone:414-479-9779
Practice Address - Fax:414-479-9775
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI318106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist