Healthcare Provider Details

I. General information

NPI: 1699797159
Provider Name (Legal Business Name): SHERRY FRANKLIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 S LANDMARK AVE
BLOOMINGTON IN
47403-5004
US

IV. Provider business mailing address

601 W 2ND ST
BLOOMINGTON IN
47403-2317
US

V. Phone/Fax

Practice location:
  • Phone: 812-353-3450
  • Fax: 812-353-3451
Mailing address:
  • Phone: 812-353-3450
  • Fax: 812-353-3451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number33004606
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: