Provider Demographics
NPI:1942783022
Name:FORD, SHARIKA (MHS, CAADC, LPC)
Entity Type:Individual
Prefix:
First Name:SHARIKA
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:MHS, CAADC, LPC
Other - Prefix:
Other - First Name:SHARIKA
Other - Middle Name:
Other - Last Name:MCCLINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:334 CARBON ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5940
Mailing Address - Country:US
Mailing Address - Phone:484-250-1604
Mailing Address - Fax:
Practice Address - Street 1:123 S 22ND ST STE 104
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3808
Practice Address - Country:US
Practice Address - Phone:484-250-1604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
PAPC011271101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional