Provider Demographics
NPI:1952456535
Name:GARRETT, SHARON ELIZABETH (LCAS, CCS)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:ELIZABETH
Last Name:GARRETT
Suffix:
Gender:F
Credentials:LCAS, CCS
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:104 N MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-2516
Mailing Address - Country:US
Mailing Address - Phone:919-496-7781
Mailing Address - Fax:919-496-1477
Practice Address - Street 1:104 N MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2516
Practice Address - Country:US
Practice Address - Phone:919-496-7781
Practice Address - Fax:919-496-1477
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNCSAPPB # 491101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6110502Medicaid