Provider Demographics
NPI:1407013626
Name:DEESCH, SHARON K (LPC, MAC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:K
Last Name:DEESCH
Suffix:
Gender:F
Credentials:LPC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 COLLEGE RD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-5194
Mailing Address - Country:US
Mailing Address - Phone:336-299-2725
Mailing Address - Fax:336-299-2083
Practice Address - Street 1:515 COLLEGE RD
Practice Address - Street 2:SUITE 18
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-5194
Practice Address - Country:US
Practice Address - Phone:336-299-2725
Practice Address - Fax:336-299-2083
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAMAC 500-120101YA0400X
NCLPC 6965101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)