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General NPI Number Information
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NPI Number | 1215584594
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Entity Type | Individual
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Provider Name | SHARON LACKEY LPC
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Gender | Female
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Dates
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Enumeration Date | 08/21/2019
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 2420 PORT NECHES AVE OFC A
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City | PORT NECHES
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State | TX
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Zip | 77651-3939
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Country | US
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Telephone | 409-853-4699
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Fax | 866-883-6818
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Provider Business Mailing Address
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Address Line | 2420 PORT NECHES AVE OFC A
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City | PORT NECHES
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State | TX
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Zip | 77651-3939
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Country | US
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Telephone | 409-344-9155
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Fax | 866-883-6818
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 81252
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 81252
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 81252
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License Number State | TX
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