1932231990 NPI number — MRS. SHARON GAIL BRUSH - INNER REFLECTIONS LCSW, ACSW, QCSW

Table of content: MRS. SHARON GAIL BRUSH - INNER REFLECTIONS LCSW, ACSW, QCSW (NPI 1932231990)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932231990 NPI number — MRS. SHARON GAIL BRUSH - INNER REFLECTIONS LCSW, ACSW, QCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRUSH - INNER REFLECTIONS
Provider First Name:
SHARON
Provider Middle Name:
GAIL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW, ACSW, QCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHARON BRUSH
Provider Other First Name:
INNER REFLECTION
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW, ACSW, QCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1932231990
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7701 N HICKORY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65202-7800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-819-5536
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1005 E. CHERRY
Provider Second Line Business Practice Location Address:
SUITE 203B
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-819-5536
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/12/2007

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:  2006013117 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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