Provider Demographics
NPI:1316186653
Name:WHEELER, SHARNISHA LICHELE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:SHARNISHA
Middle Name:LICHELE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 COLIN DR STE 1
Mailing Address - Street 2:
Mailing Address - City:EAST YAPHANK
Mailing Address - State:NY
Mailing Address - Zip Code:11967-1521
Mailing Address - Country:US
Mailing Address - Phone:631-205-5820
Mailing Address - Fax:
Practice Address - Street 1:141 COLIN DRIVE
Practice Address - Street 2:SUITE 1
Practice Address - City:EAST YAPHANK
Practice Address - State:NY
Practice Address - Zip Code:11967-1521
Practice Address - Country:US
Practice Address - Phone:631-205-5820
Practice Address - Fax:631-205-5826
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0786631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical