Provider Demographics
NPI:1316336191
Name:COLLINS, SHARON D (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:D
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:TIRPAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 HARVARD DR
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-9763
Mailing Address - Country:US
Mailing Address - Phone:732-935-0397
Mailing Address - Fax:
Practice Address - Street 1:19 HARVARD DR
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-9763
Practice Address - Country:US
Practice Address - Phone:732-935-0397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046087001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical