Provider Demographics
NPI:1962913251
Name:GONZALEZ, SHARON (LMSW)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:DOMENECH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11 PARK PL APT 407
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4255
Mailing Address - Country:US
Mailing Address - Phone:347-698-1024
Mailing Address - Fax:
Practice Address - Street 1:600 E 233RD ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2604
Practice Address - Country:US
Practice Address - Phone:718-920-9950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1161961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY10258OtherMEDICARE