Provider Demographics
NPI:1366595357
Name:KAPLAN, SHERYL M (MSW)
Entity type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:M
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:SHERIE
Other - Middle Name:M
Other - Last Name:KAPLAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:4936 W PINE BLVD APT 11
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1418
Mailing Address - Country:US
Mailing Address - Phone:314-367-6654
Mailing Address - Fax:
Practice Address - Street 1:130 S BEMISTON AVE STE 704
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-1928
Practice Address - Country:US
Practice Address - Phone:314-367-7470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0047351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO491860508Medicaid