Provider Demographics
NPI:1689982720
Name:KROLL, SHARON BETH (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:BETH
Last Name:KROLL
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 2ND AVE S
Mailing Address - Street 2:APT 112
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6680
Mailing Address - Country:US
Mailing Address - Phone:360-951-1407
Mailing Address - Fax:
Practice Address - Street 1:2201 LIND AVENUE SW, SUITE 160
Practice Address - Street 2:SUITE 160
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057
Practice Address - Country:US
Practice Address - Phone:425-525-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW602703281041C0700X
NY1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool