Provider Demographics
NPI:1407689714
Name:POOL, SHARON
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:POOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1872 SUNSET AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-3152
Mailing Address - Country:US
Mailing Address - Phone:513-800-5512
Mailing Address - Fax:
Practice Address - Street 1:1001 W MAIN ST STE F
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-7211
Practice Address - Country:US
Practice Address - Phone:513-800-5512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 171R00000X, 171W00000X, 171WH0202X, 172A00000X, 251C00000X, 251X00000X, 253Z00000X, 261QA0600X, 347C00000X, 385HR2050X, 385HR2060X, 374U00000X
OH33.021104225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171R00000XOther Service ProvidersInterpreter
No171W00000XOther Service ProvidersContractor
No171WH0202XOther Service ProvidersContractorHome Modifications
No172A00000XOther Service ProvidersDriver
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No347C00000XTransportation ServicesPrivate Vehicle
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child