Provider Demographics
NPI:1184074023
Name:GILMORE, SHARON (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:GILMORE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:SUNNY SIDE
Mailing Address - State:GA
Mailing Address - Zip Code:30284-0280
Mailing Address - Country:US
Mailing Address - Phone:770-689-8776
Mailing Address - Fax:
Practice Address - Street 1:230 W COLLEGE ST STE D
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4249
Practice Address - Country:US
Practice Address - Phone:678-688-3133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0055331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical