Healthcare Provider Details

I. General information

NPI: 1679482871
Provider Name (Legal Business Name): KIM EILEEN SHARROTT PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIM HESLIN

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 MONROE ST APT 4
HOBOKEN NJ
07030-7664
US

IV. Provider business mailing address

215 MONROE ST APT 4
HOBOKEN NJ
07030-7664
US

V. Phone/Fax

Practice location:
  • Phone: 609-335-8983
  • Fax:
Mailing address:
  • Phone: 609-335-8983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number028439
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number028439
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: