| Sharon Thyne, Llc | |
|
1845 N Farwell Ave Suite 310 Milwaukee WI 53202-9849 | |
| (414) 719-8398 | |
| Not Available |
| Full Name | Sharon Thyne, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1845 N Farwell Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Sharon E Thyne (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4147198398 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sharon Thyne, Llc 1845 N Farwell Ave Suite 310 Milwaukee WI 53202-9849 Ph: (414) 719-8398 | Sharon Thyne, Llc 1845 N Farwell Ave Suite 310 Milwaukee WI 53202-9849 Ph: (414) 719-8398 |
| NPI Number | 1467859967 |
|---|---|
| Provider Enumeration Date | 11/26/2014 |
| Last Update Date | 11/26/2014 |
| Medicare PECOS PAC ID | 6709109010 |
|---|---|
| Medicare Enrollment ID | O20141217001857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467859967 | NPI | - | NPPES |
| 39228000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 3113-123 (Wisconsin) | Primary |
| Provider Name | Sharon E Thyne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124135231 PECOS PAC ID: 1951625854 Enrollment ID: I20150126000577 |
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