Provider Demographics
NPI:1164659835
Name:SHARR, PEGGY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:
Last Name:SHARR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ANSONBOROUGH LN STE 604
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-6816
Mailing Address - Country:US
Mailing Address - Phone:319-353-6366
Mailing Address - Fax:319-384-8843
Practice Address - Street 1:100 ANSONBOROUGH LN STE 604
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-6816
Practice Address - Country:US
Practice Address - Phone:319-353-6366
Practice Address - Fax:319-384-8843
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007279104100000X, 1041C0700X
GACSW008412104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical