Provider Demographics
NPI:1013062397
Name:SHARPE, GINA L (MSW)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:L
Last Name:SHARPE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 ORANGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2529
Mailing Address - Country:US
Mailing Address - Phone:973-519-1618
Mailing Address - Fax:973-509-1618
Practice Address - Street 1:303 CLAREMONT AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2813
Practice Address - Country:US
Practice Address - Phone:973-509-1618
Practice Address - Fax:973-509-1618
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC008348001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical