Provider Demographics
NPI:1518044296
Name:MCQUAIDE, SHARON ANNE (LCSW PHD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANNE
Last Name:MCQUAIDE
Suffix:
Gender:F
Credentials:LCSW PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HOLIDAY PT RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:CT
Mailing Address - Zip Code:06784-1624
Mailing Address - Country:US
Mailing Address - Phone:860-355-2539
Mailing Address - Fax:860-350-6658
Practice Address - Street 1:19 HOLIDAY PT RD
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:CT
Practice Address - Zip Code:06784-1624
Practice Address - Country:US
Practice Address - Phone:860-355-2539
Practice Address - Fax:860-350-6658
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0006771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
140000677CT01OtherANTHEM
140000677CT01OtherANTHEM