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NPI Code Detail

MEDICARE: SUSAN SHERWOOD LCSW

MEDICARE: SUSAN SHERWOOD 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
11041C0700XClinical Social WorkerL2998OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144219114
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN SHERWOOD LCSW
Provider Business Mailing Address
First Line : 1776 SW MADISON ST
Second Line :
City : PORTLAND
State : OR
Zip : 97205-1715
Country : US
Telephone Number : 503-224-1044
Fax Number : 503-621-2235
Provider Business Practice Location Address
First Line : 1776 SW MADISON ST
Second Line :
City : PORTLAND
State : OR
Zip : 97205-1715
Country : US
Telephone Number : 503-224-1044
Fax Number : 503-621-2235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 07/08/2007

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Directions to “ SUSAN SHERWOOD LCSW” Practice Location

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