Healthcare Provider Details

I. General information

NPI: 1326603671
Provider Name (Legal Business Name): SHARON SULLIVAN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 07/24/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5449 S SEMORAN BLVD #216-C
ORLANDO FL
32822
US

IV. Provider business mailing address

5449 S SEMORAN BLVD #216-C
ORLANDO FL
32822
US

V. Phone/Fax

Practice location:
  • Phone: 689-213-8215
  • Fax: 407-598-7797
Mailing address:
  • Phone: 689-213-8215
  • Fax: 407-598-7797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH23725
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: