Provider Demographics
NPI:1881989390
Name:STEPHENS-TRASK, SHERYL Y (LCSW-C)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:Y
Last Name:STEPHENS-TRASK
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 SILVER SPRING AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4617
Mailing Address - Country:US
Mailing Address - Phone:301-565-0720
Mailing Address - Fax:301-565-0721
Practice Address - Street 1:817 SILVER SPRING AVE STE 408
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4617
Practice Address - Country:US
Practice Address - Phone:301-565-0720
Practice Address - Fax:301-565-0721
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD169861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical