Provider Demographics
NPI:1730843707
Name:BAXTER, SHARON (LPC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:BAXTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 AARON ST
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-1839
Mailing Address - Country:US
Mailing Address - Phone:334-350-9444
Mailing Address - Fax:
Practice Address - Street 1:127 S COURT SQ
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-0401
Practice Address - Country:US
Practice Address - Phone:334-655-4522
Practice Address - Fax:334-460-0899
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC05042101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional