Provider Demographics
NPI:1407325715
Name:SHARP, KADE (LICSW)
Entity Type:Individual
Prefix:
First Name:KADE
Middle Name:
Last Name:SHARP
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 KEENE RD BLDG O
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-7754
Mailing Address - Country:US
Mailing Address - Phone:509-627-2600
Mailing Address - Fax:
Practice Address - Street 1:3321 W KENNEWICK AVE STE 150
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2968
Practice Address - Country:US
Practice Address - Phone:509-783-2085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA101YM00800XMedicaid