Provider Demographics
NPI:1740685353
Name:SHERRICK, SUSAN (LPC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:SHERRICK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 LORDSHIP RD
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-7525
Mailing Address - Country:US
Mailing Address - Phone:203-257-9736
Mailing Address - Fax:
Practice Address - Street 1:346 LORDSHIP RD
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-7525
Practice Address - Country:US
Practice Address - Phone:203-257-9736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002123101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor