Provider Demographics
NPI:1760523104
Name:MOSLEY, SHARON HOLLEY (LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:HOLLEY
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6208 FAYETTEVILLE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6286
Mailing Address - Country:US
Mailing Address - Phone:919-695-7170
Mailing Address - Fax:
Practice Address - Street 1:6208 FAYETTEVILLE RD STE 106
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6286
Practice Address - Country:US
Practice Address - Phone:919-695-7170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4203101Y00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102846Medicaid
NC6103203Medicaid