Provider Demographics
NPI:1326285438
Name:REYNOLDS, SHARON ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ELIZABETH
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6754 HYDRANGEA RD
Mailing Address - Street 2:
Mailing Address - City:ORE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75683-3585
Mailing Address - Country:US
Mailing Address - Phone:903-790-6534
Mailing Address - Fax:
Practice Address - Street 1:6754 HYDRANGEA RD
Practice Address - Street 2:
Practice Address - City:ORE CITY
Practice Address - State:TX
Practice Address - Zip Code:75683-3585
Practice Address - Country:US
Practice Address - Phone:903-762-2889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX035131041C0700X
AR2181-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical