Healthcare Provider Details

I. General information

NPI: 1033162136
Provider Name (Legal Business Name): BRIAN HOWARD SHARP PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MARKET ST
MANNINGTON WV
26582-1132
US

IV. Provider business mailing address

201 MARKET ST
MANNINGTON WV
26582-1132
US

V. Phone/Fax

Practice location:
  • Phone: 304-986-1753
  • Fax: 304-986-1753
Mailing address:
  • Phone: 304-986-1753
  • Fax: 304-986-1753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number638
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number638
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: