Provider Demographics
NPI:1982456620
Name:MATA, SHARON ROCIO (MA, LPC,LCDC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ROCIO
Last Name:MATA
Suffix:
Gender:F
Credentials:MA, LPC,LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6717 EVERHART RD APT 2015
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2365
Mailing Address - Country:US
Mailing Address - Phone:956-267-6217
Mailing Address - Fax:
Practice Address - Street 1:6717 EVERHART RD APT 2015
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2365
Practice Address - Country:US
Practice Address - Phone:956-267-6217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85328101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor