Provider Demographics
NPI:1326110586
Name:THOMPSON, SHARON SMITH (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:SMITH
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:PATRICIA
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:760 N AUBURNDALE ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38107-4530
Mailing Address - Country:US
Mailing Address - Phone:901-679-5344
Mailing Address - Fax:
Practice Address - Street 1:35 S AUBURNDALE ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3916
Practice Address - Country:US
Practice Address - Phone:901-729-3900
Practice Address - Fax:901-729-2737
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2743103TC1900X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service