Provider Demographics
NPI:1316366248
Name:WILSON, SHARON GREY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:GREY
Last Name:WILSON
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 1:1150 CHERRY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MEADOWS OF DAN
Mailing Address - State:VA
Mailing Address - Zip Code:24120-3870
Mailing Address - Country:US
Mailing Address - Phone:276-952-2727
Mailing Address - Fax:276-952-2627
Practice Address - Street 1:1150 CHERRY CREEK RD
Practice Address - Street 2:
Practice Address - City:MEADOWS OF DAN
Practice Address - State:VA
Practice Address - Zip Code:24120-3870
Practice Address - Country:US
Practice Address - Phone:276-952-2727
Practice Address - Fax:276-952-2627
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040082571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical