Provider Demographics
NPI:1699873596
Name:METAXAS, SHARON J (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:J
Last Name:METAXAS
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 1:1521 CONCORD PIKE
Mailing Address - Street 2:STE 103
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803
Mailing Address - Country:US
Mailing Address - Phone:302-428-0205
Mailing Address - Fax:302-428-1123
Practice Address - Street 1:1521 CONCORD PIKE
Practice Address - Street 2:STE 103
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803
Practice Address - Country:US
Practice Address - Phone:302-428-0205
Practice Address - Fax:302-428-1123
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ10000581104100000X
PASW011989L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker