Provider Demographics
NPI:1780791525
Name:SHERMAN, ROXANNE KAY (LCSW-R)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:KAY
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:K
Other - Last Name:HEATH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 14890
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12212-4890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2215 BURDETT AVE
Practice Address - Street 2:BEHAVORIAL HEALTH DEPT
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180
Practice Address - Country:US
Practice Address - Phone:518-833-6470
Practice Address - Fax:518-271-3682
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0420831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB4003Medicare ID - Type UnspecifiedUPSTATE MEDICARE