Provider Demographics
NPI:1134184351
Name:RAFFERTY, SHARON H (LCSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:H
Last Name:RAFFERTY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11439 SPRING CYPRESS RD
Mailing Address - Street 2:BLDG A
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-6521
Mailing Address - Country:US
Mailing Address - Phone:281-586-6490
Mailing Address - Fax:281-823-7466
Practice Address - Street 1:14335 TORREY CHASE BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1634
Practice Address - Country:US
Practice Address - Phone:281-586-6490
Practice Address - Fax:281-823-7466
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS237041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82153WMedicare PIN
TX82153WOtherBC/BS NUMBER