| Sherry Blair Institute For Inspirational Change, Llc | |
|
80 Park St Montclair NJ 07042 | |
| (973) 746-0333 | |
| (973) 746-1533 |
| Full Name | Sherry Blair Institute For Inspirational Change, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 80 Park St, Montclair, New Jersey |
| Authorized Official Name and Position | Sherry Ann Blair (OWNER) |
| Authorized Official Contact | 9737460333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sherry Blair Institute For Inspirational Change, Llc 216 Walnut St Montclair NJ 07042-2926 Ph: (973) 943-6356 | Sherry Blair Institute For Inspirational Change, Llc 80 Park St Montclair NJ 07042 Ph: (973) 746-0333 |
| NPI Number | 1477702884 |
|---|---|
| Provider Enumeration Date | 09/10/2008 |
| Last Update Date | 06/04/2018 |
| Medicare PECOS PAC ID | 9537226659 |
|---|---|
| Medicare Enrollment ID | O20090317000362 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477702884 | NPI | - | NPPES |
| 0032484 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (New Jersey) | Primary |
| Provider Name | Sherry Blair |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588716583 PECOS PAC ID: 7911064027 Enrollment ID: I20090317000254 |
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