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General NPI Number Information
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NPI Number | 1841353356
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Entity Type | Individual
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Provider Name | SHERRI L. BIANCAVILLA LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 950 S OYSTER BAY RD
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City | HICKSVILLE
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State | NY
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Zip | 11801-3510
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Country | US
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Telephone | 516-938-7568
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Fax | 516-390-9109
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Provider Business Mailing Address
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Address Line | 256 MAIN ST STE 1108
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City | NORTHPORT
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State | NY
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Zip | 11768-1733
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Country | US
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Telephone | 516-640-2908
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0728991
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License Number State | NY
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