Healthcare Provider Details

I. General information

NPI: 1528149606
Provider Name (Legal Business Name): SHARON KAY TROXELL MASTER SOCIAL WORK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARON GREGORY

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date: 08/19/2010
Reactivation Date: 02/27/2012

III. Provider practice location address

930 N 14TH ST
NEW CASTLE IN
47362-4311
US

IV. Provider business mailing address

240 N TILLOTSON AVE.
MUNCIE IN
47304
US

V. Phone/Fax

Practice location:
  • Phone: 765-521-2450
  • Fax: 765-593-6001
Mailing address:
  • Phone: 765-288-1928
  • Fax: 765-741-0359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34008792A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: