Provider Demographics
NPI:1386918647
Name:SHARP, JILLIAN A (LCSW)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:A
Last Name:SHARP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1916
Mailing Address - Country:US
Mailing Address - Phone:973-735-3348
Mailing Address - Fax:
Practice Address - Street 1:620 MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:PA
Practice Address - Zip Code:19403-1916
Practice Address - Country:US
Practice Address - Phone:973-735-3348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-05
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05361400101Y00000X
PACW0162911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor