Provider Demographics
NPI:1255665477
Name:KIRLIK, SHARON BARBARA (PHD, LCSW, LCAS-A)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:BARBARA
Last Name:KIRLIK
Suffix:
Gender:F
Credentials:PHD, LCSW, LCAS-A
Other - Prefix:DR
Other - First Name:SHARON
Other - Middle Name:BARBARA
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 PRESTON EXECUTIVE DR STE J
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8488
Mailing Address - Country:US
Mailing Address - Phone:919-521-0665
Mailing Address - Fax:919-882-9260
Practice Address - Street 1:1004 WERRINGTON DR
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-6017
Practice Address - Country:US
Practice Address - Phone:919-554-0177
Practice Address - Fax:919-552-3062
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0064091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007408Medicaid