1982742441 NPI number — KIRK A. SHARROCK LPCC-S

Table of content: KIRK A. SHARROCK LPCC-S (NPI 1982742441)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982742441 NPI number — KIRK A. SHARROCK LPCC-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHARROCK
Provider First Name:
KIRK
Provider Middle Name:
A.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPCC-S
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982742441
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7251 SAWMILL RD.
Provider Second Line Business Mailing Address:
SUITE 150
Provider Business Mailing Address City Name:
DUBLIN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-766-0161
Provider Business Mailing Address Fax Number:
614-766-0298

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7251 SAWMILL RD.
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
DUBLIN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-766-0161
Provider Business Practice Location Address Fax Number:
614-766-0298
Provider Enumeration Date:
02/04/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  E-4369 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)