Provider Demographics
NPI:1679582969
Name:WHITE, SHARON LYNN (MSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:WHITE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 DEVEREAUX AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-3003
Mailing Address - Country:US
Mailing Address - Phone:215-743-4137
Mailing Address - Fax:
Practice Address - Street 1:146 LAKEVIEW DR S
Practice Address - Street 2:SUITE 300
Practice Address - City:GIBBSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08026-1018
Practice Address - Country:US
Practice Address - Phone:856-784-2500
Practice Address - Fax:856-784-7700
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC013083001041C0700X
PACW0130091041C0700X
NJ37FI00146100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ315386000OtherAMERIHEALTH
NJ4354603OtherAMERIHEALTH ADMINISTRATOR