Provider Demographics
NPI:1316014509
Name:SHARPE, JENNIFER D (MSW,LCSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:D
Last Name:SHARPE
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W TRYON ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278
Mailing Address - Country:US
Mailing Address - Phone:919-245-2440
Mailing Address - Fax:919-644-3312
Practice Address - Street 1:300 W TRYON ST
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278
Practice Address - Country:US
Practice Address - Phone:919-245-2440
Practice Address - Fax:919-644-3312
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1041C0700X1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2873297AMedicare ID - Type UnspecifiedMEDICARE PROVIDER NO.