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General NPI Number Information
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NPI Number | 1568196384
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Entity Type | Individual
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Provider Name | SHANNON SARTHOU
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Gender | Female
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Dates
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Enumeration Date | 07/16/2022
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Last Update Date | 11/13/2022
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Provider Practice Location Address
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Address Line | 2 PARAGON WAY STE 800
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City | FREEHOLD
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State | NJ
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Zip | 07728-9573
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Country | US
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Telephone | 732-393-8391
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Fax | 732-308-4500
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Provider Business Mailing Address
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Address Line | 2 PARAGON WAY STE 800
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City | FREEHOLD
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State | NJ
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Zip | 07728-9573
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Country | US
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Telephone | 732-393-8391
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Fax | 732-308-4500
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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 | 83714
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 20345
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC06139100
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License Number State | NJ
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