Healthcare Provider Details

I. General information

NPI: 1063679736
Provider Name (Legal Business Name): SHERI MARIE CROSSETT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 11/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 N MAIN ST
WARSAW NY
14569-1326
US

IV. Provider business mailing address

34 N MAIN ST
WARSAW NY
14569-1326
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-0220
  • Fax:
Mailing address:
  • Phone: 585-786-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: