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NPI Code Detail

MEDICARE: MS. AMISSA LYNN SHARROCK LPC

MEDICARE: MS. AMISSA LYNN SHARROCK LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor16166TX

General Provider Information

NPI Number : 1093049330
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMISSA LYNN SHARROCK LPC
Provider Business Mailing Address
First Line : 4001 W 15TH ST STE 465
Second Line :
City : PLANO
State : TX
Zip : 75093-5845
Country : US
Telephone Number : 972-396-4134
Fax Number : 972-396-4142
Provider Business Practice Location Address
First Line : 4001 W 15TH ST STE 465
Second Line :
City : PLANO
State : TX
Zip : 75093-5845
Country : US
Telephone Number : 972-396-4134
Fax Number : 972-396-4142
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2009
Last Update Date : 12/08/2020

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