Provider Demographics
NPI:1396892337
Name:WHITE, SHARON DENISE (MSS, LCSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:DENISE
Last Name:WHITE
Suffix:
Gender:F
Credentials:MSS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 W ALBEMARLE AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-1127
Mailing Address - Country:US
Mailing Address - Phone:610-946-1607
Mailing Address - Fax:
Practice Address - Street 1:370 REED RD
Practice Address - Street 2:SUITE 214
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-4016
Practice Address - Country:US
Practice Address - Phone:610-946-1607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0139091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01168203Medicaid
PA01168203Medicaid