Provider Demographics
NPI:1013013499
Name:MCCOMBIE, SHARON LEE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LEE
Last Name:MCCOMBIE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2522
Mailing Address - Country:US
Mailing Address - Phone:973-635-1195
Mailing Address - Fax:973-644-5074
Practice Address - Street 1:283 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2522
Practice Address - Country:US
Practice Address - Phone:973-635-1195
Practice Address - Fax:973-644-5074
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001324001041C0700X
MA1001571041C0700X
NJ37F100110700106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
652787Medicare ID - Type Unspecified