Provider Demographics
NPI:1518015981
Name:THOMPSON, SHARON J (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:J
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 PARK AVE
Mailing Address - Street 2:SUITE 803
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1953
Mailing Address - Country:US
Mailing Address - Phone:508-799-0688
Mailing Address - Fax:508-752-0469
Practice Address - Street 1:255 PARK AVE
Practice Address - Street 2:SUITE 803
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1953
Practice Address - Country:US
Practice Address - Phone:508-799-0688
Practice Address - Fax:508-752-0469
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1145331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical