Provider Demographics
NPI:1548560915
Name:SHARP, LAURA ENZINNA (LSCSW, LCAC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ENZINNA
Last Name:SHARP
Suffix:
Gender:F
Credentials:LSCSW, LCAC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:CATHERINE
Other - Last Name:SHARP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 467
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-0467
Mailing Address - Country:US
Mailing Address - Phone:316-284-6400
Mailing Address - Fax:316-284-6490
Practice Address - Street 1:1901 E. FIRST ST.
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-0467
Practice Address - Country:US
Practice Address - Phone:316-284-6400
Practice Address - Fax:316-284-6490
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44111041C0700X
KS577101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)