Provider Demographics
NPI:1073177481
Name:PEDROSA, SHARON IVETTE (LMSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:IVETTE
Last Name:PEDROSA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:IVETTE
Other - Last Name:PEDROSA-ARIAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 9174
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06601-9174
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 LAFAYETTE BLVD
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-4725
Practice Address - Country:US
Practice Address - Phone:203-212-9224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT121381041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical