Provider Demographics
NPI:1831693688
Name:IMBER, SHARON AMY (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:AMY
Last Name:IMBER
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 1:185 PLEASANT ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-6888
Mailing Address - Country:US
Mailing Address - Phone:617-650-9929
Mailing Address - Fax:
Practice Address - Street 1:185 PLEASANT ST APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-6888
Practice Address - Country:US
Practice Address - Phone:617-650-9929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1131231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical