Provider Demographics
NPI:1942358122
Name:MEAHAN, SHARON ANN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANN
Last Name:MEAHAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 S GLOBE ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-3930
Mailing Address - Country:US
Mailing Address - Phone:734-891-3767
Mailing Address - Fax:734-446-2754
Practice Address - Street 1:190 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1236
Practice Address - Country:US
Practice Address - Phone:734-416-3341
Practice Address - Fax:734-416-3345
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010599891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N23250Medicare ID - Type Unspecified