Provider Demographics
NPI:1780296939
Name:SHERMAN, PHILLIP MAURICE (LLMSW)
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:MAURICE
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17790 MAISONS DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-3801
Mailing Address - Country:US
Mailing Address - Phone:313-915-8072
Mailing Address - Fax:
Practice Address - Street 1:17790 MAISONS DR
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-3801
Practice Address - Country:US
Practice Address - Phone:313-915-8072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010952911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical