Provider Demographics
NPI:1053515213
Name:SHARPE, MELINDA E (LCSW)
Entity type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:E
Last Name:SHARPE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-3268
Mailing Address - Country:US
Mailing Address - Phone:203-284-0238
Mailing Address - Fax:203-284-0238
Practice Address - Street 1:521 N ELM ST
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-3268
Practice Address - Country:US
Practice Address - Phone:203-284-0238
Practice Address - Fax:203-284-0238
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0010021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical