Provider Demographics
NPI:1568012581
Name:SMITH, SHARON M
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1167
Mailing Address - Street 2:
Mailing Address - City:SHADY SPRING
Mailing Address - State:WV
Mailing Address - Zip Code:25918-1167
Mailing Address - Country:US
Mailing Address - Phone:304-228-1955
Mailing Address - Fax:304-763-0664
Practice Address - Street 1:230 N EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-4139
Practice Address - Country:US
Practice Address - Phone:304-763-5257
Practice Address - Fax:304-763-0664
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor