Provider Demographics
NPI:1508564717
Name:COOPER, SHARHONDA HINTON (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:SHARHONDA
Middle Name:HINTON
Last Name:COOPER
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 1:4621 WORTHINGTON LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-4736
Mailing Address - Country:US
Mailing Address - Phone:919-744-8058
Mailing Address - Fax:
Practice Address - Street 1:4621 WORTHINGTON LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-4736
Practice Address - Country:US
Practice Address - Phone:919-744-8058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0085271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty