Provider Demographics
NPI:1023691896
Name:SHARI PHILLIPS LLC
Entity type:Organization
Organization Name:SHARI PHILLIPS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:218-640-7368
Mailing Address - Street 1:310 3RD ST NW
Mailing Address - Street 2:
Mailing Address - City:WADENA
Mailing Address - State:MN
Mailing Address - Zip Code:56482-1118
Mailing Address - Country:US
Mailing Address - Phone:218-640-7368
Mailing Address - Fax:
Practice Address - Street 1:116 ASH AVE NW
Practice Address - Street 2:SUITE 2
Practice Address - City:WADENA
Practice Address - State:MN
Practice Address - Zip Code:56482-1347
Practice Address - Country:US
Practice Address - Phone:218-640-7368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty