Provider Demographics
NPI:1497360507
Name:SHARPLEY, SUSANA BRYCE
Entity type:Individual
Prefix:MS
First Name:SUSANA
Middle Name:BRYCE
Last Name:SHARPLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29424-3519
Mailing Address - Country:US
Mailing Address - Phone:404-375-8064
Mailing Address - Fax:
Practice Address - Street 1:175 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29424-7558
Practice Address - Country:US
Practice Address - Phone:404-375-8064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2025-02-07
Deactivation Date:2024-01-02
Deactivation Code:
Reactivation Date:2025-02-07
Provider Licenses
StateLicense IDTaxonomies
SC7221101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional