Provider Demographics
NPI:1881152825
Name:SHERWIN, LINDSEY (MSC, RDT, EXAT)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:SHERWIN
Suffix:
Gender:F
Credentials:MSC, RDT, EXAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E 83RD ST APT 5D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7299
Mailing Address - Country:US
Mailing Address - Phone:347-286-8430
Mailing Address - Fax:
Practice Address - Street 1:515 E 83RD ST APT 5D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-7299
Practice Address - Country:US
Practice Address - Phone:347-286-8430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-08
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY893101200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101200000XBehavioral Health & Social Service ProvidersDrama Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY105634951Medicaid