Provider Demographics
NPI:1538171178
Name:SHARPES, KELLY R (LPC)
Entity type:Individual
Prefix:MR
First Name:KELLY
Middle Name:R
Last Name:SHARPES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-4632
Mailing Address - Country:US
Mailing Address - Phone:540-434-1941
Mailing Address - Fax:540-434-0132
Practice Address - Street 1:644 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801
Practice Address - Country:US
Practice Address - Phone:540-564-5629
Practice Address - Fax:540-433-4338
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003342101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1417027608OtherGROUP NPI
VA521597OtherVALUE OPTIONS PROVIDER NO
VA237121OtherANTHEM PROVIDER NUMBER
VA085781MOtherSENTARA PROVIDER NUMBER
VA220650OtherCOMPSYCH PROVIDER NUMBER
VA010007976Medicaid
VA11527360OtherCAQH PROVIDER NUMBER
VA2199743OtherCIGNA PROVIDER NUMBER
VAC05754OtherMEDICARE GROUP NUMBER