Provider Demographics
NPI:1740361773
Name:SUMNER, SHERENELLE F (LCSW-R)
Entity type:Individual
Prefix:
First Name:SHERENELLE
Middle Name:F
Last Name:SUMNER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 TOMS LN
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1727
Mailing Address - Country:US
Mailing Address - Phone:845-566-3097
Mailing Address - Fax:845-566-3657
Practice Address - Street 1:790 ROUTE 211 E
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-1448
Practice Address - Country:US
Practice Address - Phone:845-764-7977
Practice Address - Fax:845-566-3657
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR059041-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical