Provider Demographics
NPI:1427348754
Name:EDMOND, SHARON (LPC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:EDMOND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 202645
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78720-2645
Mailing Address - Country:US
Mailing Address - Phone:512-662-1395
Mailing Address - Fax:512-672-8611
Practice Address - Street 1:9009 FM 620
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-4200
Practice Address - Country:US
Practice Address - Phone:512-662-1395
Practice Address - Fax:512-672-8611
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65324101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional