MEDICARE: SHARON H RAFFERTY LCSW

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	S23704	TX

General Provider Information

NPI Number	:	1134184351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON H RAFFERTY LCSW

Provider Business Mailing Address
First Line	:	11439 SPRING CYPRESS RD
Second Line	:	BLDG A
City	:	TOMBALL
State	:	TX
Zip	:	77377-6521
Country	:	US
Telephone Number	:	281-586-6490
Fax Number	:	281-823-7466

Provider Business Practice Location Address
First Line	:	14335 TORREY CHASE BLVD
Second Line	:	SUITE E
City	:	HOUSTON
State	:	TX
Zip	:	77014-1634
Country	:	US
Telephone Number	:	281-586-6490
Fax Number	:	281-823-7466

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	03/22/2017

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