Provider Demographics
NPI:1942741830
Name:PETROSKY, SHARON ANN (LMHC)
Entity type:Individual
Prefix:MISS
First Name:SHARON
Middle Name:ANN
Last Name:PETROSKY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1872
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-1872
Mailing Address - Country:US
Mailing Address - Phone:808-854-9318
Mailing Address - Fax:
Practice Address - Street 1:65-1190 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8431
Practice Address - Country:US
Practice Address - Phone:808-887-6460
Practice Address - Fax:800-885-4126
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
HI1128101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician