Provider Demographics
NPI:1801942305
Name:DONATELLI, SHARON (LISW)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:DONATELLI
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 1:5465 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2155
Mailing Address - Country:US
Mailing Address - Phone:419-885-8800
Mailing Address - Fax:419-885-8600
Practice Address - Street 1:5465 MAIN ST
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2155
Practice Address - Country:US
Practice Address - Phone:419-885-8800
Practice Address - Fax:419-885-8600
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0007878104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0007878OtherLISW