Provider Demographics
NPI:1124211347
Name:COFFEY, SHARON LOUISE (PSYD, LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LOUISE
Last Name:COFFEY
Suffix:
Gender:F
Credentials:PSYD, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 GARRETT ST STE 109
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3123
Mailing Address - Country:US
Mailing Address - Phone:540-347-2221
Mailing Address - Fax:
Practice Address - Street 1:39 GARRETT ST STE 109
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3123
Practice Address - Country:US
Practice Address - Phone:540-347-2221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003330101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health