Provider Demographics
NPI:1346599982
Name:MARCUM, SHARON ROSE (LMSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ROSE
Last Name:MARCUM
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 1:4 SUN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5012
Mailing Address - Country:US
Mailing Address - Phone:501-400-5641
Mailing Address - Fax:
Practice Address - Street 1:4 SUN VALLEY RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5012
Practice Address - Country:US
Practice Address - Phone:501-400-5641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6244-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical