Provider Demographics
NPI:1811567555
Name:SHARKEY, MIRANDA LYNN (LMSW)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:LYNN
Last Name:SHARKEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:LYNN
Other - Last Name:BAUCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:10 SYMPHONY CIR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14201-1363
Mailing Address - Country:US
Mailing Address - Phone:716-783-3100
Mailing Address - Fax:716-883-0645
Practice Address - Street 1:10 SYMPHONY CIR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201-1363
Practice Address - Country:US
Practice Address - Phone:716-783-3100
Practice Address - Fax:716-883-0645
Is Sole Proprietor?:No
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical