Provider Demographics
NPI:1932474871
Name:PULATTIE, SHARON L (LMFT, LCDC)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:L
Last Name:PULATTIE
Suffix:
Gender:F
Credentials:LMFT, LCDC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:L
Other - Last Name:LAVIN-PULATTIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT, LCDC
Mailing Address - Street 1:420 KATY XING
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-4728
Mailing Address - Country:US
Mailing Address - Phone:512-869-2995
Mailing Address - Fax:
Practice Address - Street 1:2508 WILLIAMS DR STE 225
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-3235
Practice Address - Country:US
Practice Address - Phone:512-843-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-10
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8948101YA0400X
TX4903106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)