Healthcare Provider Details

I. General information

NPI: 1952210379
Provider Name (Legal Business Name): SHARON NISTICO LMHC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 SLUGA DR
NEW WINDSOR NY
12553-8270
US

IV. Provider business mailing address

5 OLD WINDSOR RD STE 418
NEW WINDSOR NY
12553-5603
US

V. Phone/Fax

Practice location:
  • Phone: 845-418-6480
  • Fax:
Mailing address:
  • Phone: 845-418-6480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHARON NISTICO
Title or Position: CEO, PSYCHOTHERAPIST
Credential: LMHC
Phone: 845-418-6480