Provider Demographics
NPI:1043847411
Name:AZEMARD, SHARONDA M (LCSW)
Entity type:Individual
Prefix:
First Name:SHARONDA
Middle Name:M
Last Name:AZEMARD
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 1:7551 WILES RD STE 104
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2064
Mailing Address - Country:US
Mailing Address - Phone:561-329-1172
Mailing Address - Fax:
Practice Address - Street 1:7551 WILES RD STE 104
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2064
Practice Address - Country:US
Practice Address - Phone:954-341-7774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW93761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical