Provider Demographics
NPI:1053520627
Name:SHERLOCK, DAVE FRANK JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVE
Middle Name:FRANK
Last Name:SHERLOCK
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:DAVE
Other - Middle Name:
Other - Last Name:SHERLOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:101 CIRBY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-4360
Mailing Address - Country:US
Mailing Address - Phone:916-787-8931
Mailing Address - Fax:916-787-8899
Practice Address - Street 1:101 CIRBY HILLS DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-4360
Practice Address - Country:US
Practice Address - Phone:916-787-8931
Practice Address - Fax:916-787-8899
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64150101YP2500X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional