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General NPI Number Information
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NPI Number | 1306667282
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Entity Type | Individual
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Provider Name | ELISHA LAVERNE SHARIF LPC
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Gender | Female
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 2021 GUADALUPE ST STE 260
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City | AUSTIN
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State | TX
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Zip | 78705-5654
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Country | US
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Telephone | 646-453-6777
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Fax |
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Provider Business Mailing Address
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Address Line | 2810 ROUTH CREEK PKWY APT 4144
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City | RICHARDSON
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State | TX
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Zip | 75082-0111
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Country | US
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Telephone |
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 89389
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License Number State | TX
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