Healthcare Provider Details

I. General information

NPI: 1932266574
Provider Name (Legal Business Name): SHARON STANTON-SHWAHLA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1648 BAY AVE SUITE 2
POINT PLEASANT BORO NJ
08742-4502
US

IV. Provider business mailing address

1648 BAY AVE SUITE 2
POINT PLEASANT BORO NJ
08742-4502
US

V. Phone/Fax

Practice location:
  • Phone: 732-899-2999
  • Fax: 732-899-6962
Mailing address:
  • Phone: 732-899-2999
  • Fax: 732-899-6962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC00167600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: