Provider Demographics
NPI:1154708360
Name:DEPAULO, SHARON ELAINE (LICSWA)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ELAINE
Last Name:DEPAULO
Suffix:
Gender:
Credentials:LICSWA
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 603
Mailing Address - Street 2:
Mailing Address - City:MARCUS
Mailing Address - State:WA
Mailing Address - Zip Code:99151-0603
Mailing Address - Country:US
Mailing Address - Phone:509-520-7227
Mailing Address - Fax:
Practice Address - Street 1:150 S ELM ST
Practice Address - Street 2:
Practice Address - City:COLVILLE
Practice Address - State:WA
Practice Address - Zip Code:99114-2834
Practice Address - Country:US
Practice Address - Phone:509-675-1447
Practice Address - Fax:509-684-3852
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-27
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC613975031041C0700X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No374J00000XNursing Service Related ProvidersDoula