Provider Demographics
NPI:1689634560
Name:SHARLOW, BETH ELLEN (MSW)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:ELLEN
Last Name:SHARLOW
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 1:11723 BERWYN ST
Mailing Address - Street 2:
Mailing Address - City:REDFORD TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48239
Mailing Address - Country:US
Mailing Address - Phone:313-937-3992
Mailing Address - Fax:
Practice Address - Street 1:33101 ANNAPOLIS
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184
Practice Address - Country:US
Practice Address - Phone:734-721-0200
Practice Address - Fax:734-721-2008
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801081649104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker