Sharon Renee Wise, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH7742 Issued in FL

Practice address

44 Shell Avenue SE
Fort Walton Beach, FL 32548

Phone

(850) 398-5255

Fax

(850) 689-8799

NPI assigned

Oct 17, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Sharon Renee Sullivan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beyond Expectations Inc.

  • Multi-Specialty Clinic/Center
  • Fort Walton Beach, FL
  • NPI 1114278686

  Mental Health

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385510400000",
    "number": "1649580275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 259",
            "city": "SHALLMAR",
            "state": "FL",
            "postal_code": "32579",
            "telephone_number": "850-362-6824",
            "fax_number": "850-362-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 SHELL AVENUE SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "32548",
            "telephone_number": "850-398-5255",
            "fax_number": "850-689-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "SHARON",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-17",
        "last_updated": "2013-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH7742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003493600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "SULLIVAN",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Beverly Wilusz, LMHC
• Abbey Winblad, PT
• Robert Edward Winkler Jr., ATC
• Anne Wise, L.M.H.C.
• Jessica Wise, M.D.
• Matthew Wisniewski, PTA
• Andrea J Witt, CRNA
• Gavin Payne Wolfe
• Tade L Wolfe, MA, CCC-SLP
• Vicky Wolfe, PHD

• Mental Health Counselor in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.