Provider Demographics
NPI:1043217417
Name:SHARP, CAROLYN (LICSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 5TH AVE NE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-4180
Mailing Address - Country:US
Mailing Address - Phone:206-291-8377
Mailing Address - Fax:
Practice Address - Street 1:8401 5TH AVE NE
Practice Address - Street 2:SUITE 103
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-4180
Practice Address - Country:US
Practice Address - Phone:206-291-8377
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000051091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical