Provider Demographics
NPI:1336416296
Name:MORALES, SHARON (LISW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 KELBURN LN
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-7571
Mailing Address - Country:US
Mailing Address - Phone:347-278-3702
Mailing Address - Fax:
Practice Address - Street 1:620 KELBURN LN
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-7571
Practice Address - Country:US
Practice Address - Phone:347-278-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2023-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083260-1101Y00000X
OHI.22038801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor