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General NPI Number Information
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NPI Number | 1033261474
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Entity Type | Individual
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Provider Name | SHARON LISA GOLDSTEIN LICSW
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 77 WARREN STREET BLDG 4
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City | BRIGHTON
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State | MA
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Zip | 02135
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Country | US
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Telephone | 617-254-1140
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Fax | 617-789-5496
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Provider Business Mailing Address
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Address Line | 2 JOSHUA PATH
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City | NATICK
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State | MA
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Zip | 01760-5882
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Country | US
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Telephone | 617-480-9292
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 111362
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License Number State | MA
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