Provider Demographics
NPI:1457535064
Name:BUDDINGTON, SHARON C (LCSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:C
Last Name:BUDDINGTON
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 1:4485 TENCH RD
Mailing Address - Street 2:SUITE 840
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6741
Mailing Address - Country:US
Mailing Address - Phone:678-436-0056
Mailing Address - Fax:770-945-7214
Practice Address - Street 1:4485 TENCH RD
Practice Address - Street 2:SUITE 840
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6741
Practice Address - Country:US
Practice Address - Phone:678-436-0056
Practice Address - Fax:770-945-7214
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0033571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical