Provider Demographics
NPI:1417187295
Name:NATHANSON, SHARMAN COHEN (MSW)
Entity Type:Individual
Prefix:
First Name:SHARMAN
Middle Name:COHEN
Last Name:NATHANSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:989 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-1308
Mailing Address - Country:US
Mailing Address - Phone:617-779-2139
Mailing Address - Fax:617-779-2101
Practice Address - Street 1:989 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1308
Practice Address - Country:US
Practice Address - Phone:617-779-2139
Practice Address - Fax:617-779-2101
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1054741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical