Healthcare Provider Details

I. General information

NPI: 1053291617
Provider Name (Legal Business Name): SHERRILEE PARTISS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 WAVERLY AVE
PATCHOGUE NY
11772-1586
US

IV. Provider business mailing address

14 FAIRVIEW CIR
MIDDLE ISLAND NY
11953-2334
US

V. Phone/Fax

Practice location:
  • Phone: 631-447-6460
  • Fax: 631-299-4200
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number123637
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: