Provider Demographics
NPI:1154085736
Name:MACLIN, SHA'RON (MS, SAC, LPC-IT)
Entity Type:Individual
Prefix:
First Name:SHA'RON
Middle Name:
Last Name:MACLIN
Suffix:
Gender:F
Credentials:MS, SAC, LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6737 W WASHINGTON ST STE 2275
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-5666
Mailing Address - Country:US
Mailing Address - Phone:414-246-2300
Mailing Address - Fax:
Practice Address - Street 1:6737 W WASHINGTON ST STE 2275
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-5666
Practice Address - Country:US
Practice Address - Phone:414-246-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4089-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional