Individual provider Active NPI

John Russell Sharp, LPCC-S

  • Mental Health Counselor
  • Tiffin, OH
National Provider Identifier
1417285735
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.0700020 Issued in OH
Practice address
4076 S Township Road 22
Tiffin, OH 44883
Phone
(517) 740-6960
NPI assigned
Nov 24, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E.0700020 OH Primary

Addresses

Primary practice location

4076 S Township Road 22
Tiffin, OH 44883

Mailing address

4076 S Township Road 22
Tiffin, OH 44883
Phone (517) 740-6960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
E.0700020OHMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1417285735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 S TOWNSHIP ROAD 22",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "44883",
            "telephone_number": "517-740-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 S TOWNSHIP ROAD 22",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "44883",
            "telephone_number": "517-740-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "JOHN",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "LPCC-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-24",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0700020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tiffin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.