Provider Demographics
NPI:1457475899
Name:ROSS, SHARON LEVINE (MSSW,LCSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LEVINE
Last Name:ROSS
Suffix:
Gender:F
Credentials:MSSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5617 WILLIAMSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2129
Mailing Address - Country:US
Mailing Address - Phone:214-354-9999
Mailing Address - Fax:972-661-8031
Practice Address - Street 1:5924 ROYAL LN
Practice Address - Street 2:SUITE 103
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-3863
Practice Address - Country:US
Practice Address - Phone:214-364-9999
Practice Address - Fax:972-661-8031
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX245831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00533EMedicare PIN