Healthcare Provider Details

I. General information

NPI: 1447245253
Provider Name (Legal Business Name): SHARRON M PATE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 11/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 S BAYLEN ST SUITE 2
PENSACOLA FL
32502-5852
US

IV. Provider business mailing address

229 S BAYLEN ST SUITE 2
PENSACOLA FL
32502-5852
US

V. Phone/Fax

Practice location:
  • Phone: 850-433-1656
  • Fax: 850-433-1996
Mailing address:
  • Phone: 850-433-1656
  • Fax: 850-433-1996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH3142
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: