Provider Demographics
NPI:1326610494
Name:SILVERSTROM, SHARON (LMSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SILVERSTROM
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 1:160 PINEVIEW LN
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-5120
Mailing Address - Country:US
Mailing Address - Phone:151-649-1821
Mailing Address - Fax:
Practice Address - Street 1:550 NY-25A
Practice Address - Street 2:
Practice Address - City:ST JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780
Practice Address - Country:US
Practice Address - Phone:631-928-4815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084478104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker