Provider Demographics
NPI:1730999236
Name:TUTTLE, SHARILYN KAY (PLMHP, PMSW)
Entity type:Individual
Prefix:
First Name:SHARILYN
Middle Name:KAY
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:PLMHP, PMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 INNATE CIR APT 301
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-6102
Mailing Address - Country:US
Mailing Address - Phone:308-850-7747
Mailing Address - Fax:
Practice Address - Street 1:659 ORLEANS DR STE 2
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3420
Practice Address - Country:US
Practice Address - Phone:308-395-7272
Practice Address - Fax:308-395-7131
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8147104100000X
NE14247101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker