Provider Demographics
NPI:1992697924
Name:SHARKEY, JACLYN NICOLE (PHD, LPC)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:NICOLE
Last Name:SHARKEY
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:JACLYN
Other - Middle Name:NICOLE
Other - Last Name:SOVOCOOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LPC
Mailing Address - Street 1:226 CARSON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19127-1305
Mailing Address - Country:US
Mailing Address - Phone:267-738-2761
Mailing Address - Fax:
Practice Address - Street 1:226 CARSON ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19127-1305
Practice Address - Country:US
Practice Address - Phone:267-738-2761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017067101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health