Provider Demographics
NPI:1629073770
Name:JOSEPH, SHARON JEAN (PH D)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:JEAN
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 PHYSICIANS WAY
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-4100
Mailing Address - Country:US
Mailing Address - Phone:304-637-5426
Mailing Address - Fax:304-637-5428
Practice Address - Street 1:58 PHYSICIANS WAY
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-4100
Practice Address - Country:US
Practice Address - Phone:304-637-5426
Practice Address - Fax:304-637-5428
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV719103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV680010446OtherRAILROAD MEDICARE
WV0164866000Medicaid
WV1047001OtherWC
WV680010446OtherRAILROAD MEDICARE
WV1047001OtherWC