Provider Demographics
NPI:1598293011
Name:SHARON SHAVIT
Entity type:Organization
Organization Name:SHARON SHAVIT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAVIT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:540-692-9428
Mailing Address - Street 1:100 CHALMERS CT
Mailing Address - Street 2:
Mailing Address - City:BERRYVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22611-1347
Mailing Address - Country:US
Mailing Address - Phone:540-692-9428
Mailing Address - Fax:540-750-4046
Practice Address - Street 1:100 CHALMERS CT
Practice Address - Street 2:
Practice Address - City:BERRYVILLE
Practice Address - State:VA
Practice Address - Zip Code:22611-1347
Practice Address - Country:US
Practice Address - Phone:540-692-9428
Practice Address - Fax:540-750-4046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-28
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040064371041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1205901857Medicaid