Provider Demographics
NPI:1700992773
Name:SPENCE, SHARON O (MSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:O
Last Name:SPENCE
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8775 CENTRE PARK DR # 564
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2177
Mailing Address - Country:US
Mailing Address - Phone:443-812-0886
Mailing Address - Fax:
Practice Address - Street 1:8775 CENTRE PARK DR # 564
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2177
Practice Address - Country:US
Practice Address - Phone:443-812-0886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD109761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical