Provider Demographics
NPI:1174789879
Name:MORINE, SHARRON CARMELL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHARRON
Middle Name:CARMELL
Last Name:MORINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5537 BLEAUX AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-0737
Mailing Address - Country:US
Mailing Address - Phone:479-872-5580
Mailing Address - Fax:479-872-5581
Practice Address - Street 1:2300 PRESTON ST
Practice Address - Street 2:STE 100
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-5762
Practice Address - Country:US
Practice Address - Phone:870-773-0700
Practice Address - Fax:870-773-0705
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1914-C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker