MEDICARE: SHARON GAYLE COUNSELING, LLC

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	101YM0800X	Mental Health Counselor	71239	TX

General Provider Information

NPI Number	:	1639602089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHARON GAYLE COUNSELING, LLC

Provider Business Mailing Address
First Line	:	2835 KELLER SPRINGS RD APT 107
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75006-4897
Country	:	US
Telephone Number	:	469-892-8011
Fax Number	:	972-381-4201

Provider Business Practice Location Address
First Line	:	2835 KELLER SPRINGS RD APT 107
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75006-4897
Country	:	US
Telephone Number	:	469-892-8011
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHARON GAYLE
Credential	:	LPC
Telephone Number	:	972-809-8272

Provider Enumeration Date	:	04/04/2017
Last Update Date	:	09/27/2024

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