Provider Demographics
NPI:1881306785
Name:SMITH, SHARNIS (LGPC,NCC)
Entity type:Individual
Prefix:
First Name:SHARNIS
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LGPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 DAYLILY DR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5034
Mailing Address - Country:US
Mailing Address - Phone:443-473-7476
Mailing Address - Fax:
Practice Address - Street 1:2831 HILLEN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-3144
Practice Address - Country:US
Practice Address - Phone:410-235-5620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP13032101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty