Provider Demographics
NPI:1821490574
Name:ALLEN, SHARON
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:ALLEN
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 1:37 MARKET ST SW
Mailing Address - Street 2:DELTA BEHAVIORAL GROUP
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025
Mailing Address - Country:US
Mailing Address - Phone:855-201-5498
Mailing Address - Fax:
Practice Address - Street 1:111 HUGHEY RD
Practice Address - Street 2:
Practice Address - City:ALEXANDER
Practice Address - State:NC
Practice Address - Zip Code:28701
Practice Address - Country:US
Practice Address - Phone:828-230-0577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-16-23623103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst