Provider Demographics
NPI:1356544985
Name:BEAL, SHERRY DANAE (MSW)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:DANAE
Last Name:BEAL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 OAKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47265-2325
Mailing Address - Country:US
Mailing Address - Phone:317-402-8686
Mailing Address - Fax:
Practice Address - Street 1:1627 N STATE ST
Practice Address - Street 2:
Practice Address - City:NORTH VERNON
Practice Address - State:IN
Practice Address - Zip Code:47265-7479
Practice Address - Country:US
Practice Address - Phone:812-592-6795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-10
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004749A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical