1053357558 NPI number — MS. SHARMAN COHEN MICHAELSON LCSW

Table of content: MS. SHARMAN COHEN MICHAELSON LCSW (NPI 1053357558)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053357558 NPI number — MS. SHARMAN COHEN MICHAELSON LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MICHAELSON
Provider First Name:
SHARMAN
Provider Middle Name:
COHEN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MICHAELSON
Provider Other First Name:
SHARMAN
Provider Other Middle Name:
COHEN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1053357558
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
709 WESTMINSTER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27410-4629
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-299-5788
Provider Business Mailing Address Fax Number:
336-283-0034

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
604 GREEN VALLEY RD
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27408-7728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-314-2221
Provider Business Practice Location Address Fax Number:
336-283-0034
Provider Enumeration Date:
06/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C002102 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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