Provider Demographics
NPI:1063213528
Name:SHARP, ANNA CORINNE (LCDC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CORINNE
Last Name:SHARP
Suffix:
Gender:
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 RAINTREE LAKES CIR
Mailing Address - Street 2:
Mailing Address - City:BIG SANDY
Mailing Address - State:TX
Mailing Address - Zip Code:75755-3602
Mailing Address - Country:US
Mailing Address - Phone:903-841-8315
Mailing Address - Fax:
Practice Address - Street 1:703 W PATTEN ST
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:TX
Practice Address - Zip Code:75773-1541
Practice Address - Country:US
Practice Address - Phone:903-535-7366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9883101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)