Provider Demographics
NPI:1538225396
Name:SHAW, SHARON V (LMHC)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:V
Last Name:SHAW
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7412
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33673-7412
Mailing Address - Country:US
Mailing Address - Phone:813-382-1902
Mailing Address - Fax:813-227-9399
Practice Address - Street 1:308 E OAK AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-2344
Practice Address - Country:US
Practice Address - Phone:813-382-1902
Practice Address - Fax:813-227-9399
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 4278101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor