Healthcare Provider Details

I. General information

NPI: 1972229110
Provider Name (Legal Business Name): SHARON NISTICO LMHC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2022
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
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:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number012880
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC01040200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: