1215904503 NPI number — MR. JANET L. SHARP M.A., LPCC-S

Table of content: MR. JANET L. SHARP M.A., LPCC-S (NPI 1215904503)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215904503 NPI number — MR. JANET L. SHARP M.A., LPCC-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHARP
Provider First Name:
JANET
Provider Middle Name:
L.
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.A., LPCC-S
Provider Gender Code:
F

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:
1215904503
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2710 DERBYSHIRE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND HEIGHTS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44106-3319
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-321-5920
Provider Business Mailing Address Fax Number:
216-321-5920

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2710 DERBYSHIRE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND HEIGHTS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44106-3319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-321-5920
Provider Business Practice Location Address Fax Number:
216-321-5920
Provider Enumeration Date:
03/05/2006

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:  E0001191-SUPV , 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)

  • Identifier: 469548 . This is a "VALUEOPTIONS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000374088 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 7797068 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 280450 . This is a "MANAGED HEALTH NETWORK" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1-9H-13611 . This is a "HORIZON BEHAVIORAL HEALTH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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