Healthcare Provider Details

I. General information

NPI: 1396651337
Provider Name (Legal Business Name): SHARON JOHNESE SHIELDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 PROVIDENCE PARK
BIRMINGHAM AL
35242-4693
US

IV. Provider business mailing address

321 ROBERTSON AVE
BIRMINGHAM AL
35215-7729
US

V. Phone/Fax

Practice location:
  • Phone: 205-329-3488
  • Fax: 205-784-3240
Mailing address:
  • Phone: 205-329-3488
  • Fax: 205-784-3240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC06143
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: