Provider Demographics
NPI:1689654865
Name:SMITH-MATHEWES, SHARON A (MED)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:A
Last Name:SMITH-MATHEWES
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W COLEMAN BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3588
Mailing Address - Country:US
Mailing Address - Phone:843-881-2727
Mailing Address - Fax:843-881-2720
Practice Address - Street 1:222 W COLEMAN BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3588
Practice Address - Country:US
Practice Address - Phone:843-881-2727
Practice Address - Fax:843-881-2720
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0964101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional