Provider Demographics
NPI:1558392829
Name:MCNAMEE, SHARON LOUSE (PHD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LOUSE
Last Name:MCNAMEE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SHARIE
Other - Middle Name:
Other - Last Name:MCNAMEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:18777 LOOKOUT CIRCLE
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126
Mailing Address - Country:US
Mailing Address - Phone:440-331-1176
Mailing Address - Fax:440-331-1176
Practice Address - Street 1:20525 CENTER RIDGE ROAD
Practice Address - Street 2:SUITE 160
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116
Practice Address - Country:US
Practice Address - Phone:440-331-1176
Practice Address - Fax:440-331-1176
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1129103TC0700X
CA7645103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH183828OtherMHN
OH2478528Medicaid
OH000000488980OtherANTHEM BLUE CROSS
OH183828OtherMHN
OH2478528Medicaid