Healthcare Provider Details

I. General information

NPI: 1295667947
Provider Name (Legal Business Name): SHARAKIS JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5241 MONTGOMERY ROAD
CINCINNATI OH
45212-1655
US

IV. Provider business mailing address

5241 MONTGOMERY ROAD
CINCINNATI OH
45212-1655
US

V. Phone/Fax

Practice location:
  • Phone: 513-993-5241
  • Fax: 513-586-2768
Mailing address:
  • Phone: 513-993-5241
  • Fax: 513-586-2768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPP-001080884
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: