Healthcare Provider Details

I. General information

NPI: 1669754313
Provider Name (Legal Business Name): SHERRY JEANNE SATCHELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2011
Last Update Date: 04/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 SE OSCEOLA ST
STUART FL
34994-2211
US

IV. Provider business mailing address

218 SE OSCEOLA ST
STUART FL
34994-2211
US

V. Phone/Fax

Practice location:
  • Phone: 772-763-9540
  • Fax: 844-269-7702
Mailing address:
  • Phone: 772-763-9540
  • Fax: 844-269-7702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW11474
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: