Provider Demographics
NPI:1225302664
Name:FURTADO, SHARON JERONIMO (LSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:JERONIMO
Last Name:FURTADO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BALSAM ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-7047
Mailing Address - Country:US
Mailing Address - Phone:508-560-1743
Mailing Address - Fax:
Practice Address - Street 1:43 HIGH STREET
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571
Practice Address - Country:US
Practice Address - Phone:508-295-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-02
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA302965104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker