Provider Demographics
NPI:1275881104
Name:DRAKE, SHARON Y (MSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:Y
Last Name:DRAKE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:Y
Other - Last Name:DRAKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:709 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-8339
Mailing Address - Country:US
Mailing Address - Phone:772-467-3097
Mailing Address - Fax:772-467-4166
Practice Address - Street 1:709 S 5TH ST
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-8339
Practice Address - Country:US
Practice Address - Phone:772-467-3097
Practice Address - Fax:772-467-4166
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health