Active NPI
Sharon D Mayock, LPC
- Mental Health Counselor
- Coventry, CT
National Provider Identifier
1306342142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3420
- Practice address
- 1171 Main St
Coventry, CT 06238-3116 - Phone
- (860) 613-5157
- NPI assigned
- Apr 2, 2018
- 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 | 3420 | CT | Primary |
Addresses
Primary practice location
1171 Main St
Coventry, CT 06238-3116
Mailing address
20 Sunset LN Apt 3E
Bolton, CT 06043-7332
Phone (860) 305-6157
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 7, 2024 through Mar 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3420 | CT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522627200000",
"number": "1306342142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 SUNSET LN APT 3E",
"city": "BOLTON",
"state": "CT",
"postal_code": "060437332",
"telephone_number": "860-305-6157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1171 MAIN ST",
"city": "COVENTRY",
"state": "CT",
"postal_code": "062383116",
"telephone_number": "860-613-5157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYOCK",
"first_name": "SHARON",
"middle_name": "D",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-02",
"last_updated": "2018-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CT",
"license": "3420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coventry, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.