MEDICARE: SHARRAY PERRY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	9533	CT

General Provider Information

NPI Number	:	1033663588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARRAY PERRY LCSW

Provider Business Mailing Address
First Line	:	232 N ELM ST
Second Line	:
City	:	WATERBURY
State	:	CT
Zip	:	06702-1516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	232 N ELM ST
Second Line	:
City	:	WATERBURY
State	:	CT
Zip	:	06702-1516
Country	:	US
Telephone Number	:	203-575-4297
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2016
Last Update Date	:	08/12/2016

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Directions to “ SHARRAY PERRY LCSW” Practice Location

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