Provider Demographics
NPI:1083697403
Name:SORRELL, SHARON ELIZABETH (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ELIZABETH
Last Name:SORRELL
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 1:3193 COUNTY ROAD 645
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-9533
Mailing Address - Country:US
Mailing Address - Phone:573-332-1272
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 127
Practice Address - Street 2:
Practice Address - City:BLACK
Practice Address - State:MO
Practice Address - Zip Code:63625-9704
Practice Address - Country:US
Practice Address - Phone:573-269-4291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0004571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical