Provider Demographics
NPI:1407814031
Name:CROSS, SHARON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:CROSS
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 1:17474 ISLE ROYALE TER
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-1936
Mailing Address - Country:US
Mailing Address - Phone:540-373-3223
Mailing Address - Fax:
Practice Address - Street 1:8479 SAINT ANTHONYS RD
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-3408
Practice Address - Country:US
Practice Address - Phone:540-775-9879
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040046621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI2129658OtherMDIPA
VA87098MOtherSENTARA
VA172279OtherANTHEM
VA87098MOtherSENTARA