Provider Demographics
NPI:1083206577
Name:STANLEY, SHAROLYN M (LPC, MA)
Entity Type:Individual
Prefix:
First Name:SHAROLYN
Middle Name:M
Last Name:STANLEY
Suffix:
Gender:F
Credentials:LPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 OAK SHADOWS RD
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-4226
Mailing Address - Country:US
Mailing Address - Phone:832-971-3400
Mailing Address - Fax:
Practice Address - Street 1:811 OAK SHADOWS RD
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4226
Practice Address - Country:US
Practice Address - Phone:832-971-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-06
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63465101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional