Basic Information
| Provider Information | |||||||||
| NPI: | 1407253305 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHARP | ||||||||
| FirstName: | STEVEN | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7502 MELYNNE TRCE | ||||||||
| Address2: | |||||||||
| City: | CANAL WINCHESTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431107721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142575401 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1925 HAYES AVE | ||||||||
| Address2: | |||||||||
| City: | SANDUSKY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448704737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195575177 | ||||||||
| FaxNumber: | 4195575179 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2014 | ||||||||
| LastUpdateDate: | 08/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | I.2203491 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.