Healthcare Provider Details

I. General information

NPI: 1508867276
Provider Name (Legal Business Name): SHARYN E WARREN L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date: 03/22/2006
Reactivation Date: 04/04/2006

III. Provider practice location address

975 WALNUT ST SUITE 357
CARY NC
27511-4268
US

IV. Provider business mailing address

975 WALNUT ST SUITE 357
CARY NC
27511-4268
US

V. Phone/Fax

Practice location:
  • Phone: 919-467-3250
  • Fax: 919-467-3250
Mailing address:
  • Phone: 919-303-7083
  • Fax: 919-467-3250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC000292
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: