Healthcare Provider Details

I. General information

NPI: 1689982720
Provider Name (Legal Business Name): SHARON BETH KROLL MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 LIND AVENUE SW, SUITE 160 SUITE 160
RENTON WA
98057
US

IV. Provider business mailing address

410 2ND AVE S APT 112
KIRKLAND WA
98033-6680
US

V. Phone/Fax

Practice location:
  • Phone: 425-525-6800
  • Fax:
Mailing address:
  • Phone: 360-951-1407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW60270328
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: