MEDICARE: SHARON MERCER SHINN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1730772005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON MERCER SHINN

Provider Business Mailing Address
First Line	:	2382 SUGAR CT SW
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28027-8945
Country	:	US
Telephone Number	:	980-521-6845
Fax Number	:

Provider Business Practice Location Address
First Line	:	8535 CLIFF CAMERON DR STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-5909
Country	:	US
Telephone Number	:	704-717-7477
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2021
Last Update Date	:	02/17/2021

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