Provider Demographics
NPI:1326504051
Name:WIMBERLY, SHARRA (LISW)
Entity type:Individual
Prefix:
First Name:SHARRA
Middle Name:
Last Name:WIMBERLY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10003 PARKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-6302
Mailing Address - Country:US
Mailing Address - Phone:216-386-3626
Mailing Address - Fax:
Practice Address - Street 1:10003 PARKVIEW AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-6302
Practice Address - Country:US
Practice Address - Phone:216-386-3626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-19
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
385H00000X
OHI.2405376104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No385H00000XRespite Care FacilityRespite Care