Provider Demographics
NPI:1558400374
Name:THOMAS, SHARON E (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:E
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-6402
Mailing Address - Country:US
Mailing Address - Phone:203-215-7064
Mailing Address - Fax:203-230-0294
Practice Address - Street 1:436 ORANGE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-6402
Practice Address - Country:US
Practice Address - Phone:203-215-7064
Practice Address - Fax:203-230-0294
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002582103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical