Provider Demographics
NPI:1932231990
Name:BRUSH - INNER REFLECTIONS, SHARON GAIL (LCSW, ACSW, QCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:GAIL
Last Name:BRUSH - INNER REFLECTIONS
Suffix:
Gender:F
Credentials:LCSW, ACSW, QCSW
Other - Prefix:
Other - First Name:INNER REFLECTION
Other - Middle Name:
Other - Last Name:SHARON BRUSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, ACSW, QCSW
Mailing Address - Street 1:7701 N HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-7800
Mailing Address - Country:US
Mailing Address - Phone:573-819-5536
Mailing Address - Fax:
Practice Address - Street 1:1005 E. CHERRY
Practice Address - Street 2:SUITE 203B
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201
Practice Address - Country:US
Practice Address - Phone:573-819-5536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060131171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical