Provider Demographics
NPI:1366176133
Name:SHARP, REBEKAH DANIELLE (LPC-MHSP (T))
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:DANIELLE
Last Name:SHARP
Suffix:
Gender:F
Credentials:LPC-MHSP (T)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 N MOUNT JULIET RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-4498
Mailing Address - Country:US
Mailing Address - Phone:615-438-3615
Mailing Address - Fax:
Practice Address - Street 1:2031 N MOUNT JULIET RD STE 201
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-4498
Practice Address - Country:US
Practice Address - Phone:615-438-3615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6096101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional