Provider Demographics
NPI:1801241732
Name:MULLINS, SHARON (LPC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:MULLINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:MULLINS-OLSHAVSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:104 W 4TH ST STE 306
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3819
Mailing Address - Country:US
Mailing Address - Phone:248-430-4224
Mailing Address - Fax:
Practice Address - Street 1:104 W 4TH ST STE 306
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-3819
Practice Address - Country:US
Practice Address - Phone:248-430-4224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401005021101YP2500X, 101YM0800X, 101YP1600X, 102X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No102X00000XBehavioral Health & Social Service ProvidersPoetry Therapist