Provider Demographics
NPI:1528288776
Name:GOLD, SHERI (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHERI
Middle Name:
Last Name:GOLD
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 1:31 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-1211
Mailing Address - Country:US
Mailing Address - Phone:914-478-7414
Mailing Address - Fax:914-478-0174
Practice Address - Street 1:267 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-1207
Practice Address - Country:US
Practice Address - Phone:914-400-9709
Practice Address - Fax:914-478-0174
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072317-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY231035OtherHEALTHNET
NYN7J521Medicare ID - Type Unspecified