Provider Demographics
NPI:1841826880
Name:SHARP, SHELBY (MS, LPCC, LAC)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:MS, LPCC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 S VAUGHN WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3438
Mailing Address - Country:US
Mailing Address - Phone:720-421-3789
Mailing Address - Fax:
Practice Address - Street 1:7251 E 49TH AVE
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-4714
Practice Address - Country:US
Practice Address - Phone:303-321-2533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-22
Last Update Date:2020-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001398101YA0400X
COLPCC.0016790101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)