Provider Demographics
NPI:1144237520
Name:DAINO, SHARON PATRICIA (MSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:PATRICIA
Last Name:DAINO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:
Other - Last Name:DAINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SAME
Mailing Address - Street 1:PO BOX 2838
Mailing Address - Street 2:
Mailing Address - City:MORIARTY
Mailing Address - State:NM
Mailing Address - Zip Code:87035-2838
Mailing Address - Country:US
Mailing Address - Phone:505-660-8626
Mailing Address - Fax:
Practice Address - Street 1:9180 ESTERO PARK COMMONS BLVD STE 2
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-3218
Practice Address - Country:US
Practice Address - Phone:505-660-8626
Practice Address - Fax:239-495-7772
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLISW I-4454101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM101511OtherVALUE OPTIONS
NM03938514Medicaid
NM03938514Medicaid