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General NPI Number Information
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NPI Number | 1033809033
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Entity Type | Organization
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Legal Business Name | SHARON SHADWELL PLLC
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 4405 7TH AVE SE STE 201
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City | LACEY
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State | WA
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Zip | 98503-1055
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Country | US
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Telephone | 360-545-3527
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Fax |
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Provider Business Mailing Address
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Address Line | 4405 7TH AVE SE STE 201
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City | LACEY
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State | WA
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Zip | 98503-1055
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Country | US
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Telephone | 360-545-3527
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | SHARON SHADWELL
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Credential | MS, MPA, LMHC
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Telephone | 360-306-9290
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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