Provider Demographics
NPI:1053676213
Name:STRACK, SHARON C (LCSWR)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:C
Last Name:STRACK
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 ROUTE 9
Mailing Address - Street 2:SUITE 7
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-4993
Mailing Address - Country:US
Mailing Address - Phone:845-632-2939
Mailing Address - Fax:845-632-2940
Practice Address - Street 1:1285 ROUTE 9
Practice Address - Street 2:SUITE 7
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4993
Practice Address - Country:US
Practice Address - Phone:845-632-2939
Practice Address - Fax:845-632-2940
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0477691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical