Provider Demographics
NPI:1417277690
Name:SHARON B. VARNUM, LCSW, LLC
Entity Type:Organization
Organization Name:SHARON B. VARNUM, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:BROWN
Authorized Official - Last Name:VARNUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-843-3700
Mailing Address - Street 1:1708 DRURY LN
Mailing Address - Street 2:
Mailing Address - City:NICHOLS HILLS
Mailing Address - State:OK
Mailing Address - Zip Code:73116-5310
Mailing Address - Country:US
Mailing Address - Phone:405-843-3700
Mailing Address - Fax:405-842-1963
Practice Address - Street 1:5500 N WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-4019
Practice Address - Country:US
Practice Address - Phone:405-843-3700
Practice Address - Fax:405-842-1963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK461723551Medicare UPIN