Provider Demographics
NPI:1275828444
Name:MCBRIDE, SHARA LYNN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARA
Middle Name:LYNN
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9521 SAN MATEO BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-2237
Mailing Address - Country:US
Mailing Address - Phone:505-288-4251
Mailing Address - Fax:888-656-1621
Practice Address - Street 1:851 ANDREA DR STE 4
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-6726
Practice Address - Country:US
Practice Address - Phone:505-324-5834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-084721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical