Provider Demographics
NPI:1063919777
Name:AHRENDSEN, SHARIFA MATTIS (MSW LCSWA)
Entity type:Individual
Prefix:MRS
First Name:SHARIFA
Middle Name:MATTIS
Last Name:AHRENDSEN
Suffix:
Gender:F
Credentials:MSW LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7330 CHAPEL HILL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-5042
Mailing Address - Country:US
Mailing Address - Phone:919-819-6082
Mailing Address - Fax:919-573-0438
Practice Address - Street 1:7330 CHAPEL HILL RD STE 206
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-5042
Practice Address - Country:US
Practice Address - Phone:919-819-6082
Practice Address - Fax:919-573-0438
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0114441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical