Provider Demographics
NPI:1952472078
Name:SHERWIN, SHEILA FOX (LCSW, LMFT)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:FOX
Last Name:SHERWIN
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 1:309 S OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3723
Mailing Address - Country:US
Mailing Address - Phone:610-566-6629
Mailing Address - Fax:
Practice Address - Street 1:309 S OLIVE ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3723
Practice Address - Country:US
Practice Address - Phone:610-566-6629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0132131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00865Medicare UPIN
PA634574Medicare ID - Type UnspecifiedMEDICARE ID NUMBER