Provider Demographics
NPI:1629015706
Name:DAVIS, SHARON MARSHALL (MEDLPC LMFT NCC)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:MARSHALL
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MEDLPC LMFT NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1576 PANTOPS MOUNTAIN PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8829
Mailing Address - Country:US
Mailing Address - Phone:580-595-1579
Mailing Address - Fax:
Practice Address - Street 1:1576 PANTOPS MOUNTAIN PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8829
Practice Address - Country:US
Practice Address - Phone:580-595-1579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004955101YP2500X
OK411106H00000X
OK177101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist