Edith Renee Sherman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2112-M Issued in AR

Practice address

134 County Road 665
Wynne, AR 72396-8402

Phone

(870) 238-5681

NPI assigned

Mar 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Group practices

Changes Behavioral Health, LLCGroup PAC ID 6103149653, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Changes Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Wynne, AR
  • NPI 1114260486
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1629249131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 COUNTY ROAD 665",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723968402",
            "telephone_number": "870-238-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 COUNTY ROAD 665",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723968402",
            "telephone_number": "870-238-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "EDITH",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2112-M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Wayne Sharp, OT
• Samantha Sharp, LPC-S
• Vicki Sharp, OTR
• Brian D. Shaw, CM
• Deena Ann Shaw, LPC
• Hannah Shipp, QBHP
• Victoria L Sides
• Dalisha Lareece Smith, MHPP
• Kara Hardin Smith, PHARM.D
• Tonya Smith, QBHB

• Clinical Social Worker in Wynne, AR
• Providers in Wynne, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.