Basic Information
| Provider Information | |||||||||
| NPI: | 1659892560 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SILVUS | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | LISW-S, LICDC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 240 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | DUNCAN FALLS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437349759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7406176995 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3405 DILLON ACRES DR | ||||||||
| Address2: | |||||||||
| City: | ZANESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437019658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404554132 | ||||||||
| FaxNumber: | 7404555322 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2017 | ||||||||
| LastUpdateDate: | 08/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | I.1700560 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 0242360 | 05 | OH | MEDICAID |