MEDICARE: SERENA SHERRILL MSW, LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LW60909972	WA
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1043563034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERENA SHERRILL MSW, LICSW

Provider Business Mailing Address
First Line	:	5101 14TH AVE NW STE 200
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-5143
Country	:	US
Telephone Number	:	425-477-9239
Fax Number	:

Provider Business Practice Location Address
First Line	:	5101 14TH AVE NW STE 200
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-5143
Country	:	US
Telephone Number	:	425-477-9239
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2012
Last Update Date	:	02/26/2026

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