Provider Demographics
NPI:1801845573
Name:KIRSCH, SHARON (MA)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:KIRSCH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12141 LADUE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8120
Mailing Address - Country:US
Mailing Address - Phone:314-878-4340
Mailing Address - Fax:314-878-4524
Practice Address - Street 1:12141 LADUE RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8120
Practice Address - Country:US
Practice Address - Phone:314-878-4340
Practice Address - Fax:314-878-4524
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000278101YM0800X
MO01354103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO118527OtherBCBC OF MO PROVIDER NUMBE
MO2258211OtherCIGNA BEHAVIORAL HEALTH