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General NPI Number Information
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NPI Number | 1184275059
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Entity Type | Individual
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Provider Name | EDWARD L. SHAROOD LCPC-C, CADA, DEEP
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Gender | Male
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Dates
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Enumeration Date | 09/23/2019
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Last Update Date | 01/19/2021
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Provider Practice Location Address
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Address Line | 1662 POST RD BLDG 2
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City | WELLS
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State | ME
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Zip | 04090-4638
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Country | US
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Telephone | 207-494-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 19 HOLLAND RD
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City | KENNEBUNK
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State | ME
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Zip | 04043-6296
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Country | US
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Telephone | 207-494-3900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAC6966
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | XL5297
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | XL5296
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License Number State | ME
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