Provider Demographics
NPI:1316085285
Name:DVORSKY, SHARON ANN (MSW,LCSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:DVORSKY
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 GRISSOM CT
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-9313
Mailing Address - Country:US
Mailing Address - Phone:810-513-1355
Mailing Address - Fax:
Practice Address - Street 1:3150 HALLMARK CT
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2173
Practice Address - Country:US
Practice Address - Phone:989-790-3366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL788477101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health