Provider Demographics
NPI:1336933779
Name:DELISLE, SHARI A (PHD)
Entity type:Individual
Prefix:MS
First Name:SHARI
Middle Name:A
Last Name:DELISLE
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 MAIN STREET, LOWER LEVEL
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-4915
Mailing Address - Country:US
Mailing Address - Phone:716-866-8228
Mailing Address - Fax:
Practice Address - Street 1:229 MAIN STREET, LOWER LEVEL
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-4915
Practice Address - Country:US
Practice Address - Phone:716-866-8228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYMFC000895106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist