Provider Demographics
NPI:1932355898
Name:BEGOUN, SHERYL ELISE (LICSW)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:ELISE
Last Name:BEGOUN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6343 52ND AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2913
Mailing Address - Country:US
Mailing Address - Phone:206-723-9629
Mailing Address - Fax:206-260-2992
Practice Address - Street 1:1601 16TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4011
Practice Address - Country:US
Practice Address - Phone:206-861-3164
Practice Address - Fax:206-461-3696
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000078221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical