Provider Demographics
NPI:1972842763
Name:SHERMAN, AMY JAY (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JAY
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SPARROW AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6312
Mailing Address - Country:US
Mailing Address - Phone:845-641-8843
Mailing Address - Fax:
Practice Address - Street 1:4 SPARROW AVE
Practice Address - Street 2:
Practice Address - City:CHESTNUT RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10977-6312
Practice Address - Country:US
Practice Address - Phone:845-641-8843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000533-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000533-1OtherMARRIAGE & FAMILY THERAPIST LICENSE #
NY20-5990303OtherTAX ID#