Provider Demographics
NPI:1063163756
Name:STEVENS, SHARON HUDSON
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:HUDSON
Last Name:STEVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6812 JARRED CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3562
Mailing Address - Country:US
Mailing Address - Phone:803-917-9641
Mailing Address - Fax:
Practice Address - Street 1:115 ATRIUM WAY BLDG SUITE221
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6371
Practice Address - Country:US
Practice Address - Phone:803-699-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82762101YP2500X
SC9593101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional