Provider Demographics
NPI:1679662571
Name:KRUMPE, SHARON WILSON (PHD, LPC, LMFT)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:WILSON
Last Name:KRUMPE
Suffix:
Gender:F
Credentials:PHD, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6072 GODWIN BLVD
Mailing Address - Street 2:POB 2387
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23432-1012
Mailing Address - Country:US
Mailing Address - Phone:757-255-2555
Mailing Address - Fax:757-255-7009
Practice Address - Street 1:6072 GODWIN BLVD
Practice Address - Street 2:POB 2387
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23432-1012
Practice Address - Country:US
Practice Address - Phone:757-255-2555
Practice Address - Fax:757-255-7009
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003187101YP2500X
VA0717001033106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA084821MOtherSENTARA
VA508183OtherVALUE OPTIONS
VA386489OtherANTHEM BLUE CROSS/BLUE SH