Healthcare Provider Details

I. General information

NPI: 1073806170
Provider Name (Legal Business Name): SHARON MARIE ULRICH LPCC, MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2011
Last Update Date: 10/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22001 FAIRMOUNT BLVD
CLEVELAND OH
44118-4819
US

IV. Provider business mailing address

22001 FAIRMONT BLVD
CLEVELAND OH
44118
US

V. Phone/Fax

Practice location:
  • Phone: 216-932-2800
  • Fax:
Mailing address:
  • Phone: 216-932-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC110154CR
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE1100154
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM1200006
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: