Provider Demographics
NPI:1104313345
Name:FORD, SHARHONDA LYNN (LCMHC)
Entity type:Individual
Prefix:
First Name:SHARHONDA
Middle Name:LYNN
Last Name:FORD
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11424 SWEETBRIAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5046
Mailing Address - Country:US
Mailing Address - Phone:443-744-0621
Mailing Address - Fax:
Practice Address - Street 1:7200 E WT HARRIS BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-7200
Practice Address - Country:US
Practice Address - Phone:443-744-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-13
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJDCATEMP-011337101YM0800X
VA0701009498101YM0800X
NC13865101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health