Provider Demographics
NPI:1427611136
Name:SHARAK, WENDY LYNN (LMHC, ATR)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:LYNN
Last Name:SHARAK
Suffix:
Gender:F
Credentials:LMHC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53B BRANDYWYNE DR
Mailing Address - Street 2:
Mailing Address - City:EAST BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-1161
Mailing Address - Country:US
Mailing Address - Phone:617-983-9258
Mailing Address - Fax:
Practice Address - Street 1:50 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4002
Practice Address - Country:US
Practice Address - Phone:617-706-2601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6393101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health