MEDICARE: SHERYL Y STEPHENS-TRASK LCSW-C

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	16986	MD

General Provider Information

NPI Number	:	1881989390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERYL Y STEPHENS-TRASK LCSW-C

Provider Business Mailing Address
First Line	:	817 SILVER SPRING AVE STE 408
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4617
Country	:	US
Telephone Number	:	301-565-0720
Fax Number	:	301-565-0721

Provider Business Practice Location Address
First Line	:	817 SILVER SPRING AVE STE 408
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4617
Country	:	US
Telephone Number	:	301-565-0720
Fax Number	:	301-565-0721

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

Provider Enumeration Date	:	06/13/2011
Last Update Date	:	06/13/2011

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