Provider Demographics
NPI:1992303986
Name:BUIE, SHARHONDA FAYE (ADC)
Entity type:Individual
Prefix:
First Name:SHARHONDA
Middle Name:FAYE
Last Name:BUIE
Suffix:
Gender:F
Credentials:ADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 918
Mailing Address - Street 2:
Mailing Address - City:BENNETTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29512-0918
Mailing Address - Country:US
Mailing Address - Phone:843-454-0841
Mailing Address - Fax:843-454-0635
Practice Address - Street 1:1035 CHERAW STREET
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-2422
Practice Address - Country:US
Practice Address - Phone:843-454-0841
Practice Address - Fax:843-454-0635
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC251S00000XMedicaid