Basic Information
Provider Information
NPI: 1598820607
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHITAKER
FirstName: SHERRY
MiddleName: S.
NamePrefix: MS.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: WALTER REED ARMY MEDICAL CENTER 6900 GEORGIA AVE NW
Address2: ATTN MCHL MAO C
City: WASHINGTON
State: DC
PostalCode: 203070001
CountryCode: US
TelephoneNumber: 2027823321
FaxNumber:  
Practice Location
Address1: WALTER REED ARMY MEDICAL CENTER 6900 GEORGIA AVE NW
Address2: ATTN MCHL MAO C
City: WASHINGTON
State: DC
PostalCode: 203070001
CountryCode: US
TelephoneNumber: 2027823321
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/27/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XLCSW-3257HIY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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