Provider Demographics
NPI:1245744135
Name:BIRTELL, SHARON KAY (LSCSW)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:KAY
Last Name:BIRTELL
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3242 SE STANLEY RD
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:KS
Mailing Address - Zip Code:66542-9631
Mailing Address - Country:US
Mailing Address - Phone:785-640-1149
Mailing Address - Fax:
Practice Address - Street 1:3242 SE STANLEY RD
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:KS
Practice Address - Zip Code:66542-9631
Practice Address - Country:US
Practice Address - Phone:785-633-3887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-30
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5285104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker