Provider Demographics
NPI:1376694133
Name:MORAN, SHARON M (LCSWR)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:M
Last Name:MORAN
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:MISS
Other - First Name:SHARON
Other - Middle Name:M
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:291 RANDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-1444
Mailing Address - Country:US
Mailing Address - Phone:716-568-1328
Mailing Address - Fax:
Practice Address - Street 1:2478 GEORGE URBAN BLVD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043
Practice Address - Country:US
Practice Address - Phone:716-799-9382
Practice Address - Fax:716-901-7407
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033253-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker