Healthcare Provider Details

I. General information

NPI: 1134637291
Provider Name (Legal Business Name): SHERRY ILENE DANSKY MAT, A.T.R.-BC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2018
Last Update Date: 01/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12601 MAYPAN DR
BOCA RATON FL
33428-4779
US

IV. Provider business mailing address

12601 MAYPAN DR
BOCA RATON FL
33428-4779
US

V. Phone/Fax

Practice location:
  • Phone: 561-596-1728
  • Fax:
Mailing address:
  • Phone: 561-596-1728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8617
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number2432
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: