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General NPI Number Information
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NPI Number | 1083785463
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Entity Type | Individual
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Provider Name | SHARON PETRONE LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 11/25/2019
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Provider Practice Location Address
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Address Line | 153 HAZARD AVE
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City | ENFIELD
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State | CT
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Zip | 06082-4592
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Country | US
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Telephone | 860-253-5020
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Fax | 860-253-5030
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Provider Business Mailing Address
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Address Line | 2 WATERSIDE XING STE 401
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City | WINDSOR
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State | CT
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Zip | 06095-1587
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Country | US
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Telephone | 860-731-5222
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Fax | 860-731-5536
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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 | 005810
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License Number State | CT
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