Provider Demographics
NPI:1437363355
Name:TUBLIN, SHARON MAE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:MAE
Last Name:TUBLIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 HENRY ST
Mailing Address - Street 2:APT. 28L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1752
Mailing Address - Country:US
Mailing Address - Phone:718-624-3259
Mailing Address - Fax:718-625-8084
Practice Address - Street 1:26 COURT ST
Practice Address - Street 2:SUITE 610
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-0103
Practice Address - Country:US
Practice Address - Phone:718-624-3259
Practice Address - Fax:718-625-8084
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP992592OtherLCSW
NYP992592OtherLCSW