Provider Demographics
NPI:1407900467
Name:BYWATER, SHARON E (MSW LCSWR)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:E
Last Name:BYWATER
Suffix:
Gender:F
Credentials:MSW LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 COLT PLACE
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3820
Mailing Address - Country:US
Mailing Address - Phone:845-566-6188
Mailing Address - Fax:
Practice Address - Street 1:2 COLT PLACE
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3820
Practice Address - Country:US
Practice Address - Phone:845-566-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0363181104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
N1A571Medicare ID - Type Unspecified