Provider Demographics
NPI:1568653343
Name:DAVIS, SHARON LEA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LEA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5247 HONEYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-4628
Mailing Address - Country:US
Mailing Address - Phone:901-210-4969
Mailing Address - Fax:
Practice Address - Street 1:4821 AMERICAN WAY
Practice Address - Street 2:SUITE 302
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-2471
Practice Address - Country:US
Practice Address - Phone:901-210-4969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC000818101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health