=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053280388
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. DANIELLE K SHERWIN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/04/2025
-----------------------------------------------------
Last Update Date | 11/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 55 ROUTE 35 STE 6
-----------------------------------------------------
City | RED BANK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07701-5918
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-784-7793
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 SHIRE WAY
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07748-3348
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-533-3932
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | TP253-102
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------