Provider Demographics
NPI:1902233943
Name:BORDOFF, SHERRI (LCSW)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:BORDOFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 COTTONWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-2763
Mailing Address - Country:US
Mailing Address - Phone:516-783-1153
Mailing Address - Fax:
Practice Address - Street 1:82 COTTONWOOD CT
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-2763
Practice Address - Country:US
Practice Address - Phone:516-783-1153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR020715-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool