Provider Demographics
NPI:1457958472
Name:WALSH, SHARON (LCSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:WALSH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 COUNTRY BROOK LN
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-2613
Mailing Address - Country:US
Mailing Address - Phone:808-722-5390
Mailing Address - Fax:
Practice Address - Street 1:2012 COUNTRY BROOK LN
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-2613
Practice Address - Country:US
Practice Address - Phone:808-722-5390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI36131041C0700X
MI68011193351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical