Provider Demographics
NPI:1073579751
Name:MAHONE, SHARLETTA KAY (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:SHARLETTA
Middle Name:KAY
Last Name:MAHONE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 SOMERSET PL
Mailing Address - Street 2:APT. 12
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-3748
Mailing Address - Country:US
Mailing Address - Phone:502-216-9477
Mailing Address - Fax:502-896-8004
Practice Address - Street 1:224 BRECKENRIDGE LN
Practice Address - Street 2:SUITE A
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3859
Practice Address - Country:US
Practice Address - Phone:502-216-9477
Practice Address - Fax:502-896-8004
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY05-0607106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist