Provider Demographics
NPI:1982265146
Name:WATERS, SHAREN MARIE (LCSW)
Entity Type:Individual
Prefix:DR
First Name:SHAREN
Middle Name:MARIE
Last Name:WATERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:SHAREN
Other - Middle Name:MARIE
Other - Last Name:PIERRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6387 E ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:46124-1064
Mailing Address - Country:US
Mailing Address - Phone:812-350-8818
Mailing Address - Fax:
Practice Address - Street 1:927 4TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-6824
Practice Address - Country:US
Practice Address - Phone:812-799-3530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34010863A1041C0700X
IN33006186A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical