Provider Demographics
NPI:1457411530
Name:RAWSTHORN, SHERRI HAYES (LCSW)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:HAYES
Last Name:RAWSTHORN
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 1:440 S PERRY ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4873
Mailing Address - Country:US
Mailing Address - Phone:678-377-6992
Mailing Address - Fax:678-377-6992
Practice Address - Street 1:440 S PERRY ST
Practice Address - Street 2:SUITE 3
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4873
Practice Address - Country:US
Practice Address - Phone:678-377-6992
Practice Address - Fax:678-377-6992
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW28831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA651167081OtherCORPORATE TAX ID