Provider Demographics
NPI:1700089547
Name:MICHAUD, SHERRY L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:L
Last Name:MICHAUD
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 1:21 SKINNER HILL RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:CT
Mailing Address - Zip Code:06232-1110
Mailing Address - Country:US
Mailing Address - Phone:860-798-2776
Mailing Address - Fax:860-498-1130
Practice Address - Street 1:15 HENNEQUIN RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:CT
Practice Address - Zip Code:06237-1309
Practice Address - Country:US
Practice Address - Phone:860-798-2776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0083551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical