Provider Demographics
NPI:1033261474
Name:GOLDSTEIN, SHARON LISA (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LISA
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 JOSHUA PATH
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-5882
Mailing Address - Country:US
Mailing Address - Phone:617-480-9292
Mailing Address - Fax:
Practice Address - Street 1:77 WARREN STREET
Practice Address - Street 2:BLDG 4
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-254-1140
Practice Address - Fax:617-789-5496
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1113621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical