Provider Demographics
NPI:1902358070
Name:DAVIS, SHARON T (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:T
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:T
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:9906 SHOSHONE CT
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-1700
Mailing Address - Country:US
Mailing Address - Phone:443-492-8557
Mailing Address - Fax:
Practice Address - Street 1:2300 GARRISON BLVD STE 210
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-2309
Practice Address - Country:US
Practice Address - Phone:443-378-3154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD198751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical