Provider Demographics
NPI:1093049330
Name:SHARROCK, AMISSA LYNN (LPC)
Entity Type:Individual
Prefix:MS
First Name:AMISSA
Middle Name:LYNN
Last Name:SHARROCK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:AMISSA
Other - Middle Name:
Other - Last Name:VANDEVOORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4001 W 15TH ST STE 465
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5845
Mailing Address - Country:US
Mailing Address - Phone:972-396-4134
Mailing Address - Fax:972-396-4142
Practice Address - Street 1:4001 W 15TH ST STE 465
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5845
Practice Address - Country:US
Practice Address - Phone:972-396-4134
Practice Address - Fax:972-396-4142
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16166101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health