Provider Demographics
NPI:1235824848
Name:CHIEFFO, SHARON
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:CHIEFFO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 N EUTAW ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-6301
Mailing Address - Country:US
Mailing Address - Phone:410-225-9185
Mailing Address - Fax:410-225-7964
Practice Address - Street 1:821 N EUTAW ST STE 101
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-6301
Practice Address - Country:US
Practice Address - Phone:410-225-9185
Practice Address - Fax:410-255-7964
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDADT2700101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)