Provider Demographics
NPI:1013133792
Name:ALLEN, SHARON KAY (LMSW)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:KAY
Last Name:ALLEN
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 1:1817 W STADIUM BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4577
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2365 S HURON PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-5156
Practice Address - Country:US
Practice Address - Phone:734-913-9548
Practice Address - Fax:734-973-7508
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010594721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical