Provider Demographics
NPI:1558847889
Name:WHITE, SHARICE JANEI (LCSW)
Entity Type:Individual
Prefix:
First Name:SHARICE
Middle Name:JANEI
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:SHARICE
Other - Middle Name:JANEI
Other - Last Name:SMART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:22919 MERRICK BLVD # 710
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2108
Mailing Address - Country:US
Mailing Address - Phone:929-260-0383
Mailing Address - Fax:
Practice Address - Street 1:140-70 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-275-6010
Practice Address - Fax:718-275-6062
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0949541041C0700X
NY100502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker