Provider Demographics
NPI:1447376009
Name:SHARP, ATASHA V (LCSW)
Entity type:Individual
Prefix:
First Name:ATASHA
Middle Name:V
Last Name:SHARP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4155
Mailing Address - Country:US
Mailing Address - Phone:401-228-3404
Mailing Address - Fax:
Practice Address - Street 1:4705A OLD POST RD
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:RI
Practice Address - Zip Code:02813-1819
Practice Address - Country:US
Practice Address - Phone:401-364-7705
Practice Address - Fax:401-364-9104
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW008971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical