Provider Demographics
NPI:1750573424
Name:MOWRER, SHARON KAY (LMHC)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:KAY
Last Name:MOWRER
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 1:7720 GREYMOOR DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46815-8755
Mailing Address - Country:US
Mailing Address - Phone:260-493-8803
Mailing Address - Fax:
Practice Address - Street 1:1415 MAGNAVOX WAY
Practice Address - Street 2:SUITE 120
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-1565
Practice Address - Country:US
Practice Address - Phone:260-760-8645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001717A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health