| Doctor Name: | SHARON A WIERENGA |
| NPI Number: | 1063485993 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA LCPC |
| License Number: | 180005274 |
| Business Practice Address: | 15030 S Ravinia Ave Ste 30 Orland Park, IL - 604623258 |
| Business Phone Number: | 7082548999 |
| Business Fax Number: | |
| Mailing Address: | 11253 S Depot St, WORTH |
| State: | IL |
| Postal Code: | 604821812 |
| Phone Number: | 7082548999 |
| Fax Number: | |
| NPI Enumeration Date: | 02/10/2006 |
| NPI Last Update Date: | 06/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180005274 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |