MEDICARE: MS. SHARON L LYMAN CORREIA MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	ISW02442	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043528359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARON L LYMAN CORREIA MSW

Provider Business Mailing Address
First Line	:	910 STAFFORD RD
Second Line	:
City	:	TIVERTON
State	:	RI
Zip	:	02878-2504
Country	:	US
Telephone Number	:	401-297-7415
Fax Number	:

Provider Business Practice Location Address
First Line	:	67 VALLEY RD
Second Line	:
City	:	MIDDLETOWN
State	:	RI
Zip	:	02842-7274
Country	:	US
Telephone Number	:	401-297-7415
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2010
Last Update Date	:	05/24/2021

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