Provider Demographics
NPI:1316166374
Name:YOUNKIN, SHARON ROSE (LICSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ROSE
Last Name:YOUNKIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HIGHLAND ST APT 14
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5153
Mailing Address - Country:US
Mailing Address - Phone:401-749-3387
Mailing Address - Fax:
Practice Address - Street 1:1130 TEN ROD RD STE E305
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4176
Practice Address - Country:US
Practice Address - Phone:401-294-0451
Practice Address - Fax:401-294-0461
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW020741041C0700X
MA2122261041C0700X
MA1140961041C0700X
CT0116661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical