Provider Demographics
NPI:1538320932
Name:OSTER, SHAROLD EDWIN (LIC ADDICTION COUNS)
Entity Type:Individual
Prefix:MR
First Name:SHAROLD
Middle Name:EDWIN
Last Name:OSTER
Suffix:
Gender:M
Credentials:LIC ADDICTION COUNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 8TH AVE NE
Mailing Address - Street 2:HAZEN MEMORIAL HOSPITAL ASSOC
Mailing Address - City:HAZEN
Mailing Address - State:ND
Mailing Address - Zip Code:58545
Mailing Address - Country:US
Mailing Address - Phone:701-748-2225
Mailing Address - Fax:
Practice Address - Street 1:510 8TH AVE NE
Practice Address - Street 2:5 SAKAKAWEA MEDICAL CENTER
Practice Address - City:HAZEN
Practice Address - State:ND
Practice Address - Zip Code:58545
Practice Address - Country:US
Practice Address - Phone:701-748-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1262101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)