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General NPI Number Information
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NPI Number | 1770706285
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Entity Type | Individual
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Provider Name | SHARON CLEVELAND L.C.P.C.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/01/2016
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Provider Practice Location Address
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Address Line | 834 FALLS AVE STE 1280
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City | TWIN FALLS
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State | ID
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Zip | 83301-3364
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Country | US
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Telephone | 208-736-9990
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Fax | 208-736-9995
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Provider Business Mailing Address
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Address Line | 80 SUNNYSIDE DR
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City | JEROME
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State | ID
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Zip | 83338-5972
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Country | US
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Telephone | 208-324-1120
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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 | 0011848
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License Number State | CO
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