Provider Demographics
NPI:1093318511
Name:MERCHANT, SHARON (PSYD, CASAC, LMFT)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:PSYD, CASAC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 MOORE AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-3534
Mailing Address - Country:US
Mailing Address - Phone:315-218-5313
Mailing Address - Fax:
Practice Address - Street 1:118 MOORE AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-3534
Practice Address - Country:US
Practice Address - Phone:315-218-5313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20118101YA0400X
NY001715106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty