Provider Demographics
NPI:1922546951
Name:GORENSTEIN, SHARON FAITH (PHD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:FAITH
Last Name:GORENSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10806 REISTERSTOWN RD STE 1E
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4620
Mailing Address - Country:US
Mailing Address - Phone:410-356-4600
Mailing Address - Fax:
Practice Address - Street 1:10806 REISTERSTOWN RD STE 1E
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4620
Practice Address - Country:US
Practice Address - Phone:410-356-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05611103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist