Basic Information
Provider Information
NPI: 1689746273
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WINGET
FirstName: SHARON
MiddleName: E.
NamePrefix: MS.
NameSuffix:  
Credential: MSW, LICSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1220 12TH ST SE
Address2: SUITE 120
City: WASHINGTON
State: DC
PostalCode: 200033722
CountryCode: US
TelephoneNumber: 2027157900
FaxNumber: 2025447314
Practice Location
Address1: 1220 12TH STREET, SE
Address2: SUITE 120
City: WASHINGTON
State: DC
PostalCode: 20003
CountryCode: US
TelephoneNumber: 2027157900
FaxNumber: 2025442314
Other Information
ProviderEnumerationDate: 11/15/2006
LastUpdateDate: 11/19/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XLC302380DCY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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