Provider Demographics
NPI:1336250034
Name:KLINE, SHARON B (LMHC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:B
Last Name:KLINE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 N COURTENAY PKWY
Mailing Address - Street 2:STE 203
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-4400
Mailing Address - Country:US
Mailing Address - Phone:321-459-1003
Mailing Address - Fax:
Practice Address - Street 1:1395 N COURTENAY PKWY
Practice Address - Street 2:STE 203
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4400
Practice Address - Country:US
Practice Address - Phone:321-459-1003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 4722101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health