MEDICARE: SHARON KEARSON LC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LC0698	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417199613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON KEARSON LC

Provider Business Mailing Address
First Line	:	7504 REMOOR RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21207-4567
Country	:	US
Telephone Number	:	410-594-0888
Fax Number	:	410-594-0741

Provider Business Practice Location Address
First Line	:	7504 REMOOR RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21207-4567
Country	:	US
Telephone Number	:	410-594-0888
Fax Number	:	410-594-0741

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2009
Last Update Date	:	07/13/2021

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