Healthcare Provider Details

I. General information

NPI: 1932474871
Provider Name (Legal Business Name): SHARON L. PULATTIE LMFT, LCDC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHARON L. LAVIN-PULATTIE LMFT, LCDC

II. Dates (important events)

Enumeration Date: 03/10/2012
Last Update Date: 03/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2508 WILLIAMS DR STE 225
GEORGETOWN TX
78628-3235
US

IV. Provider business mailing address

420 KATY XING
GEORGETOWN TX
78626-4728
US

V. Phone/Fax

Practice location:
  • Phone: 512-843-0400
  • Fax:
Mailing address:
  • Phone: 512-869-2995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number8948
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4903
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: