Provider Demographics
NPI:1720589880
Name:DEWEY, SHARON ANN (PC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:DEWEY
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:396 LIBERTY LN
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2718
Mailing Address - Country:US
Mailing Address - Phone:614-674-4391
Mailing Address - Fax:
Practice Address - Street 1:396 LIBERTY LN
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2718
Practice Address - Country:US
Practice Address - Phone:614-674-4391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0003312101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health