Provider Demographics
NPI:1962546135
Name:HOLLANDSWORTH, SHARON RUTH (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:RUTH
Last Name:HOLLANDSWORTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 W WOODCROFT PKWY
Mailing Address - Street 2:#3C
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7726
Mailing Address - Country:US
Mailing Address - Phone:919-401-5896
Mailing Address - Fax:919-956-4094
Practice Address - Street 1:1301 FAYETTEVILLE ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2325
Practice Address - Country:US
Practice Address - Phone:919-956-4060
Practice Address - Fax:919-956-4094
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0012091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical