Provider Demographics
NPI:1013471317
Name:CHURCH, SHARON J (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:J
Last Name:CHURCH
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 ELLICOTT STREET NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4026
Mailing Address - Country:US
Mailing Address - Phone:202-285-6462
Mailing Address - Fax:
Practice Address - Street 1:6188 OXON HILL ROAD
Practice Address - Street 2:SUITE 500
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3136
Practice Address - Country:US
Practice Address - Phone:301-567-0400
Practice Address - Fax:301-567-7900
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10601101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional