MEDICARE: SHARON E SUDOL MA, 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
1	101YP2500X	Professional Counselor	0701010541	VA

General Provider Information

NPI Number	:	1265703177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON E SUDOL MA, LPC

Provider Business Mailing Address
First Line	:	2302 COLONIAL AVE SW STE F
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24015-3100
Country	:	US
Telephone Number	:	540-566-9706
Fax Number	:

Provider Business Practice Location Address
First Line	:	2302 COLONIAL AVE SW STE F
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24015-3100
Country	:	US
Telephone Number	:	540-566-9706
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2012
Last Update Date	:	03/02/2026

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