Provider Demographics
NPI:1659313757
Name:SHARPE, ALLISON (MA, LCMHC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SHARPE
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 BROAD ST STE 1527
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-3205
Mailing Address - Country:US
Mailing Address - Phone:603-236-7774
Mailing Address - Fax:603-217-5554
Practice Address - Street 1:154 BROAD ST STE 1527
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-3205
Practice Address - Country:US
Practice Address - Phone:603-236-7774
Practice Address - Fax:603-217-5554
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5485101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30427252Medicaid