Provider Demographics
NPI:1942392808
Name:BECKER, SHERRY (LCSW)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 AIKEN ST
Mailing Address - Street 2:G-2
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-2157
Mailing Address - Country:US
Mailing Address - Phone:203-845-0234
Mailing Address - Fax:203-845-0234
Practice Address - Street 1:71 EAST AVE
Practice Address - Street 2:SUITE T
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-4903
Practice Address - Country:US
Practice Address - Phone:646-675-6275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0049321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical