Provider Demographics
NPI:1679553028
Name:SCHARFENKAMP, JOHN C (MA)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:SCHARFENKAMP
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8010 DEERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-4526
Mailing Address - Country:US
Mailing Address - Phone:248-207-3396
Mailing Address - Fax:
Practice Address - Street 1:8010 DEERWOOD RD
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48348-4526
Practice Address - Country:US
Practice Address - Phone:248-207-3396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301001290103T00000X
MI68010177811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical