Provider Demographics
NPI:1154895365
Name:SHARON, JESSICA BOYD (LMFT, LCAS)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:BOYD
Last Name:SHARON
Suffix:
Gender:F
Credentials:LMFT, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 DABNEY DR STE B
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-3946
Mailing Address - Country:US
Mailing Address - Phone:252-572-2625
Mailing Address - Fax:252-572-2955
Practice Address - Street 1:510 DABNEY DR STE B
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-3946
Practice Address - Country:US
Practice Address - Phone:252-572-2625
Practice Address - Fax:252-572-2955
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-22
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2323106H00000X
NCLCAS-25533101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty