Provider Demographics
NPI:1407957442
Name:POLK-SADOWNIK, SHARON (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:POLK-SADOWNIK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1093 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5695
Mailing Address - Country:US
Mailing Address - Phone:617-264-7400
Mailing Address - Fax:617-264-7500
Practice Address - Street 1:1093 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445
Practice Address - Country:US
Practice Address - Phone:617-264-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1020951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP02641OtherBLUE CROSS BLUE SHIELD
MAAO24382OtherHARVARD PILGRIM/PCBH
MA738012OtherTUFTS HEALTH PLAN
MAAO24382OtherHARVARD PILGRIM/PCBH