Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | LC6092 | MD |
N | 101YP1600X | Pastoral Counselor | LC6092 | MD |
Y | 101YP2500X | Professional Counselor | LC6092 | MD |
NPI | 1073865689 |
---|---|
Provider Name | Sharon Mcclurkin |
First Address | Frederick, MD 21702-4135 |
Second Address | Frederick, MD 21702-4135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2012 |
Last Update Date | 09/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
829489 | (05) | MD |