Provider Demographics
NPI:1326603671
Name:SULLIVAN, SHARON (LMHC)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5449 S SEMORAN BLVD
Mailing Address - Street 2:#216-C
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822
Mailing Address - Country:US
Mailing Address - Phone:689-213-8215
Mailing Address - Fax:407-598-7797
Practice Address - Street 1:5449 S SEMORAN BLVD
Practice Address - Street 2:#216-C
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822
Practice Address - Country:US
Practice Address - Phone:689-213-8215
Practice Address - Fax:407-598-7797
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-02
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMH23725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health