MEDICARE: SHERRY LYNN BRASLAVSKY LCSW

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	1041C0700X	Clinical Social Worker	7180-C	AR

General Provider Information

NPI Number	:	1306282397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY LYNN BRASLAVSKY LCSW

Provider Business Mailing Address
First Line	:	4300 W 7TH ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-5446
Country	:	US
Telephone Number	:	501-257-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	11121 BEAR DR
Second Line	:
City	:	FARMINGTON
State	:	AR
Zip	:	72730-2717
Country	:	US
Telephone Number	:	479-422-9581
Fax Number	:

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

Provider Enumeration Date	:	05/16/2013
Last Update Date	:	03/28/2024

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