Provider Demographics
NPI:1700616349
Name:SHARARA, NADIA (MA, NCC, LPC)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:SHARARA
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14620 SCARBOROUGH CT
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-1011
Mailing Address - Country:US
Mailing Address - Phone:708-673-3162
Mailing Address - Fax:
Practice Address - Street 1:14620 SCARBOROUGH CT
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-1011
Practice Address - Country:US
Practice Address - Phone:708-673-3162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178020204101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional