Provider Demographics
NPI:1790241438
Name:SHARPE, VANESSA LAVERNE
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:LAVERNE
Last Name:SHARPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79A CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-1134
Mailing Address - Country:US
Mailing Address - Phone:609-265-2047
Mailing Address - Fax:609-265-2193
Practice Address - Street 1:79A CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-1134
Practice Address - Country:US
Practice Address - Phone:609-265-2047
Practice Address - Fax:609-265-2193
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health