Kenneth Barry Sharoff, LCSWC
Individual provider Active NPI Clinical Social Worker · Phoenix, MD
NPI 1629101381 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1629101381
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2647 (MD)
- Practice address
- 1 Cross Creek CT
Phoenix, MD 21131 - Phone
- (410) 771-4070
- NPI assigned
- Mar 13, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2647 | MD | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2647 | MD | Yes |
Addresses
Primary practice location
1 Cross Creek CT
Phoenix, MD 21131
Mailing address
1 Cross Creek CT
Phoenix, MD 21131
Phone (410) 771-4070
Other providers in Phoenix, MD
- John Jerome Pycha
- Amy Ruth Rakusin
- Rhythms, Inc
- Hong Rosado
- Ashley H Ruocco
- Nancy Lee Sharoff
- Gabrielle Siegel
- Nancy Simpson
- Alexander Haas Smith
- Rachel Smith
All providers in Phoenix, MD · Clinical Social Worker in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.