Provider Demographics
NPI:1023602505
Name:BARNES, SHARON LOUISE (LPCC-SUPV)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LOUISE
Last Name:BARNES
Suffix:
Gender:F
Credentials:LPCC-SUPV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 MATTIS DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-2610
Mailing Address - Country:US
Mailing Address - Phone:937-203-1919
Mailing Address - Fax:
Practice Address - Street 1:1880 MATTIS DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45439-2610
Practice Address - Country:US
Practice Address - Phone:937-203-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0000602-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health