MEDICARE: SHERRI LOCKWOOD L.I.S.W.

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	I0007647	OH

General Provider Information

NPI Number	:	1356306526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRI LOCKWOOD L.I.S.W.

Provider Business Mailing Address
First Line	:	1251 NILLES RD STE 5
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-7205
Country	:	US
Telephone Number	:	513-939-0300
Fax Number	:	513-939-0310

Provider Business Practice Location Address
First Line	:	1251 NILLES RD STE 5
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-7205
Country	:	US
Telephone Number	:	513-939-0300
Fax Number	:	513-939-0310

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	08/19/2013

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