Provider Demographics
NPI:1639601586
Name:FLAHERTY, SHARON (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:FLAHERTY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 COUNTRY WALK BLVD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-5153
Mailing Address - Country:US
Mailing Address - Phone:908-242-4618
Mailing Address - Fax:
Practice Address - Street 1:776 COMMONS WAY
Practice Address - Street 2:BLDG J
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6431
Practice Address - Country:US
Practice Address - Phone:908-242-4618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2091103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical