Individual provider Active NPI

Dave Frank Sherlock Jr., LCSW

  • Clinical Social Worker
  • Roseville, CA
National Provider Identifier
1053520627
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
64150 Issued in CA
Practice address
101 Cirby Hills Dr
Roseville, CA 95678-4360
Phone
(916) 787-8931
Fax
(916) 787-8899
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 64150 CA
Clinical Social Worker 1041C0700X 64150 CA Primary

Addresses

Primary practice location

101 Cirby Hills Dr
Roseville, CA 95678-4360

Mailing address

101 Cirby Hills Dr
Roseville, CA 95678-4360
Phone (916) 787-8931

Other names 1

  • Mr. Dave Sherlock Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
64150CAMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1053520627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CIRBY HILLS DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956784360",
            "telephone_number": "916-787-8931",
            "fax_number": "916-787-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIRBY HILLS DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956784360",
            "telephone_number": "916-787-8931",
            "fax_number": "916-787-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERLOCK",
        "first_name": "DAVE",
        "middle_name": "FRANK",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "64150",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "64150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVE",
            "last_name": "SHERLOCK",
            "prefix": "MR.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.