Provider Demographics
NPI:1770672487
Name:SALINE, SHARON (PSYD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SALINE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 CENTER ST STE 303
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3062
Mailing Address - Country:US
Mailing Address - Phone:413-586-6900
Mailing Address - Fax:413-584-0530
Practice Address - Street 1:43 CENTER ST STE 303
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3062
Practice Address - Country:US
Practice Address - Phone:413-586-6900
Practice Address - Fax:413-584-0530
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8012103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW5108501Medicare PIN