Healthcare Provider Details

I. General information

NPI: 1215024179
Provider Name (Legal Business Name): SHARON RILEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HUMMEL BLDG US RT 39
BERLIN OH
44610
US

IV. Provider business mailing address

259 SANDUSKY ST
ASHLAND OH
44805
US

V. Phone/Fax

Practice location:
  • Phone: 330-893-8100
  • Fax: 330-893-7209
Mailing address:
  • Phone: 419-289-1876
  • Fax: 419-281-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC7964
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberC7964
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: