MEDICARE: MS. LUCIANA REBECCA SHARPE LCMHCA

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	101YM0800X	Mental Health Counselor	A21113	NC

General Provider Information

NPI Number	:	1871383570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LUCIANA REBECCA SHARPE LCMHCA

Provider Business Mailing Address
First Line	:	120 W MARTIN LUTHER KING JR DR
Second Line	:
City	:	WASHINGTON
State	:	NC
Zip	:	27889-4906
Country	:	US
Telephone Number	:	252-644-1097
Fax Number	:

Provider Business Practice Location Address
First Line	:	98 RED OAK DR
Second Line	:
City	:	WASHINGTON
State	:	NC
Zip	:	27889-5801
Country	:	US
Telephone Number	:	252-402-3865
Fax Number	:

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

Provider Enumeration Date	:	05/07/2025
Last Update Date	:	05/07/2025

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