Provider Demographics
NPI:1992199723
Name:SHARPE, CHRISTOPHER (LCSW, LISW)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:SHARPE
Suffix:
Gender:M
Credentials:LCSW, LISW
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:T
Other - Last Name:SHARPE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4425 MILLS CIVIC PKWY UNIT 701
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-5451
Mailing Address - Country:US
Mailing Address - Phone:515-494-2797
Mailing Address - Fax:
Practice Address - Street 1:4617 WOODLAND AVE UNIT 4
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1763
Practice Address - Country:US
Practice Address - Phone:515-494-2797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-18
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1249651041C0700X
IA1112121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1992199723OtherIRS CP575 METACHANGE THERAPY