MEDICARE: SHARON GREENBAUM LGSW

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	104100000X	Social Worker	50080099	DC

General Provider Information

NPI Number	:	1538564943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON GREENBAUM LGSW

Provider Business Mailing Address
First Line	:	1631 S ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-6443
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1631 S ST NW APT 107
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-6410
Country	:	US
Telephone Number	:	302-547-6618
Fax Number	:

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

Provider Enumeration Date	:	10/28/2014
Last Update Date	:	10/28/2014

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