Provider Demographics
NPI:1336368042
Name:CONWAY, SHARON LEE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LEE
Last Name:CONWAY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3 HEWLETT PL
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-1612
Mailing Address - Country:US
Mailing Address - Phone:516-676-3181
Mailing Address - Fax:516-676-3181
Practice Address - Street 1:7559 263RD ST
Practice Address - Street 2:SUITE 140
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1150
Practice Address - Country:US
Practice Address - Phone:718-470-8053
Practice Address - Fax:718-962-2742
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002548-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health