Provider Demographics
NPI:1457366221
Name:SATIN, SHERRY H (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:H
Last Name:SATIN
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 1:104 GAIR STREET
Mailing Address - Street 2:
Mailing Address - City:PIERMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10968-1098
Mailing Address - Country:US
Mailing Address - Phone:845-398-3640
Mailing Address - Fax:845-398-0942
Practice Address - Street 1:104 GAIR STREET
Practice Address - Street 2:
Practice Address - City:PIERMONT
Practice Address - State:NY
Practice Address - Zip Code:10968-1098
Practice Address - Country:US
Practice Address - Phone:845-398-3640
Practice Address - Fax:845-398-0942
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO289921041C0700X
104100000X
RO28992-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02036051Medicaid
NY02036051Medicaid