Provider Demographics
NPI:1710783873
Name:LARKINS, SHARDONAY (LSW)
Entity type:Individual
Prefix:
First Name:SHARDONAY
Middle Name:
Last Name:LARKINS
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 DR MLK JR BLVD
Mailing Address - Street 2:APT 406
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102
Mailing Address - Country:US
Mailing Address - Phone:908-696-3096
Mailing Address - Fax:
Practice Address - Street 1:671 DR MLK JR BLVD
Practice Address - Street 2:APT 406
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102
Practice Address - Country:US
Practice Address - Phone:908-696-3096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07241300104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker