Provider Demographics
NPI:1598132383
Name:EBERHARDT, SHARI
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:
Last Name:EBERHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JOURNEY MENTAL HEALTH CENTER
Mailing Address - Street 2:25 KESSEL CT
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711
Mailing Address - Country:US
Mailing Address - Phone:608-280-3145
Mailing Address - Fax:608-280-2428
Practice Address - Street 1:JOURNEY MENTAL HEALTH CENTER
Practice Address - Street 2:25 KESSEL CT
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711
Practice Address - Country:US
Practice Address - Phone:608-280-3145
Practice Address - Fax:608-280-2428
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI189691363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily