Provider Demographics
NPI:1841353356
Name:BIANCAVILLA, SHERRI L (LCSW-R)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:L
Last Name:BIANCAVILLA
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:
Other - Last Name:KAPLAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:256 MAIN ST
Mailing Address - Street 2:STE 1108
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-1733
Mailing Address - Country:US
Mailing Address - Phone:516-640-2908
Mailing Address - Fax:
Practice Address - Street 1:950 S OYSTER BAY RD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3510
Practice Address - Country:US
Practice Address - Phone:516-938-7568
Practice Address - Fax:516-390-9109
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07289911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical