Provider Demographics
NPI:1497733778
Name:SHARON BARNETT MS,CCC-SLP, LLC
Entity Type:Organization
Organization Name:SHARON BARNETT MS,CCC-SLP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:719-650-1033
Mailing Address - Street 1:11600 GREEN SPRING RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80925-9537
Mailing Address - Country:US
Mailing Address - Phone:719-650-1033
Mailing Address - Fax:855-420-5895
Practice Address - Street 1:11600 GREEN SPRING RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80925-9537
Practice Address - Country:US
Practice Address - Phone:719-650-1033
Practice Address - Fax:855-420-5895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05301271Medicaid