Female

Sharayah K. Provost LPC

Professional Counselor in Brookfield, WI(View on Map)

Full Name

Sharayah K Provost LPC

NPI Number

1477025823

NPI Type

Individual Provider

Gender

Female

Enumeration Date

12/26/2018

Specialties

(Taxonomies)

Code

101YP2500X

Primary Taxonomy

Yes

Licenses

State

Wisconsin
Wisconsin

License Number

7206-125
3367-226

Contact
Information

Purpose

Mailing
Location

Address

W175N11120 STONEWOOD DR
16535 W BLUEMOUND RD STE 305

City

Germantown
Brookfield

State

WI
WI

Postal Code

53022-6511
53005-5936

Country

US
US

Telephone Number

(800) 438-1772
(800) 438-1770

Identifiers

Identifier

100084565

Identifier State

WI

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/10/2020

Provider Address

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