Healthcare Provider Details

I. General information

NPI: 1851829220
Provider Name (Legal Business Name): SHARON MCMILLAN LPC, AACDC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 08/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SHILOH RD NW STE 1840
KENNESAW GA
30144
US

IV. Provider business mailing address

405 TALLMADGE RD
CUYAHOGA FALLS OH
44221-3362
US

V. Phone/Fax

Practice location:
  • Phone: 877-752-5262
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1400344
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number101073
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC009926
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: