Provider Demographics
NPI:1063763837
Name:LACAY, SHARON A (ASW, LMSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:A
Last Name:LACAY
Suffix:
Gender:F
Credentials:ASW, LMSW
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:A
Other - Last Name:TRABULUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9246
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-0246
Mailing Address - Country:US
Mailing Address - Phone:516-946-9588
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:6B
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-6873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW31355104100000X
NYLMSW085663-1104100000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health