Active NPI
Sharon Ann Hetherington, LPC
- Mental Health Counselor
- Waco, TX
National Provider Identifier
1184046765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12708
- Practice address
- 5207 Lake Shore Dr Ste B
Waco, TX 76710-1732 - Phone
- (254) 772-8055
- Fax
- (254) 772-3019
- NPI assigned
- Jan 15, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 12708 | TX | Primary |
Addresses
Primary practice location
5207 Lake Shore Dr Ste B
Waco, TX 76710-1732
Mailing address
5207 Lake Shore Dr Ste B
Waco, TX 76710-1732
Phone (254) 772-8055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12708 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553472000000",
"number": "1184046765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5207 LAKE SHORE DR STE B",
"city": "WACO",
"state": "TX",
"postal_code": "767101732",
"telephone_number": "254-772-8055",
"fax_number": "254-772-3019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5207 LAKE SHORE DR STE B",
"city": "WACO",
"state": "TX",
"postal_code": "767101732",
"telephone_number": "254-772-8055",
"fax_number": "254-772-3019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HETHERINGTON",
"first_name": "SHARON",
"middle_name": "ANN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-15",
"last_updated": "2019-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "12708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.