Provider Demographics
NPI:1801144688
Name:CARPENTER, SHARON ANN (MSW/LICSW)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:ANN
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MSW/LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 HORIZON ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:LUNENBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01462-1104
Mailing Address - Country:US
Mailing Address - Phone:978-582-5515
Mailing Address - Fax:
Practice Address - Street 1:435 KING ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-1275
Practice Address - Country:US
Practice Address - Phone:978-692-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1102751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical