Provider Demographics
NPI:1386260255
Name:MARSHALL, SHARA (MS, MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:SHARA
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MS, MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 MERRION PARK LN
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6316
Mailing Address - Country:US
Mailing Address - Phone:919-937-3324
Mailing Address - Fax:
Practice Address - Street 1:2402 S MIAMI BLVD STE 108
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-4928
Practice Address - Country:US
Practice Address - Phone:919-572-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker