Provider Demographics
NPI:1043360779
Name:FONKE, SHARON LEE (MA,LPC, LMFT)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:LEE
Last Name:FONKE
Suffix:
Gender:F
Credentials:MA,LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 COUNTY ROAD 202
Mailing Address - Street 2:
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642-3761
Mailing Address - Country:US
Mailing Address - Phone:832-423-3093
Mailing Address - Fax:
Practice Address - Street 1:3355 BEE CAVE RD
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6775
Practice Address - Country:US
Practice Address - Phone:832-423-3093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3866101YM0800X
TX1719106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist