Healthcare Provider Details

I. General information

NPI: 1336650076
Provider Name (Legal Business Name): SHARON D TRUSS MA, LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHARON DENISE TRUSS MA, LLPC

II. Dates (important events)

Enumeration Date: 10/20/2017
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 JOLLY OAK RD
OKEMOS MI
48864
US

IV. Provider business mailing address

6549 TOWN CENTER DR STE A
CLARKSTON MI
48346-4824
US

V. Phone/Fax

Practice location:
  • Phone: 517-679-2050
  • Fax:
Mailing address:
  • Phone: 248-620-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401016268
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: