Healthcare Provider Details

I. General information

NPI: 1053013391
Provider Name (Legal Business Name): SHERRI GERARD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5280 E ATHERTON ST APT 136
LONG BEACH CA
90815-3958
US

IV. Provider business mailing address

5280 E ATHERTON ST APT 136
LONG BEACH CA
90815-3958
US

V. Phone/Fax

Practice location:
  • Phone: 630-244-8509
  • Fax:
Mailing address:
  • Phone: 630-244-8509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW110516
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: