Provider Demographics
NPI:1073669370
Name:FOWLER, SHARON G (LPC, LPCS, CTS)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:G
Last Name:FOWLER
Suffix:
Gender:F
Credentials:LPC, LPCS, CTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4122 CLEMSON BLVD
Mailing Address - Street 2:SUITE 1 C
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1100
Mailing Address - Country:US
Mailing Address - Phone:864-225-3560
Mailing Address - Fax:864-225-3560
Practice Address - Street 1:4122 CLEMSON BLVD
Practice Address - Street 2:SUITE 1 C
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1100
Practice Address - Country:US
Practice Address - Phone:864-225-3560
Practice Address - Fax:864-225-3560
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1545101YP2500X
SC3007101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional