Provider Demographics
NPI:1336034917
Name:SHARKEY SUPPORTIVE SOLUTIONS LLC
Entity type:Organization
Organization Name:SHARKEY SUPPORTIVE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:407-775-9452
Mailing Address - Street 1:1620 SCARLET OAK LOOP
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-6160
Mailing Address - Country:US
Mailing Address - Phone:407-775-9452
Mailing Address - Fax:
Practice Address - Street 1:1620 SCARLET OAK LOOP
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-6160
Practice Address - Country:US
Practice Address - Phone:407-775-9452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty