Provider Demographics
NPI:1144280389
Name:ELWELL, SHARON VIRGINIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:VIRGINIA
Last Name:ELWELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 HAY TER LOWR LEVEL6
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-4650
Mailing Address - Country:US
Mailing Address - Phone:610-253-4446
Mailing Address - Fax:610-253-4414
Practice Address - Street 1:1901 HAY TER LOWR LEVEL6
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042
Practice Address - Country:US
Practice Address - Phone:610-253-4446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2827101YA0400X
PAPS016019103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7257479OtherAETNA
PA556931000OtherMAGELLAN HEALTH SERVICES
PA105892VA9Medicare PIN