Provider Demographics
NPI:1215024179
Name:RILEY, SHARON (LPC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:RILEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 SANDUSKY ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805
Mailing Address - Country:US
Mailing Address - Phone:419-289-1876
Mailing Address - Fax:419-281-6430
Practice Address - Street 1:HUMMEL BLDG
Practice Address - Street 2:US RT 39
Practice Address - City:BERLIN
Practice Address - State:OH
Practice Address - Zip Code:44610
Practice Address - Country:US
Practice Address - Phone:330-893-8100
Practice Address - Fax:330-893-7209
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC7964101YM0800X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy