Provider Demographics
NPI:1235366006
Name:FRANCOFISHER, SHARON ANNE (LPCCS)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANNE
Last Name:FRANCOFISHER
Suffix:
Gender:F
Credentials:LPCCS
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:MCQUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCCS
Mailing Address - Street 1:71 CAVALIER BLVD STE 303
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-5172
Mailing Address - Country:US
Mailing Address - Phone:859-282-0204
Mailing Address - Fax:859-282-0361
Practice Address - Street 1:71 CAVALIER BLVD STE 303
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-5172
Practice Address - Country:US
Practice Address - Phone:859-282-0204
Practice Address - Fax:859-282-0361
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY103084101YM0800X, 101Y00000X
KY1429101YM0800X
KYKY-1429101YP2500X
OHC0700360101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100627070Medicaid
KY610661458OtherTAX ID
KY7100404120Medicaid
OH0166275Medicaid