Provider Demographics
NPI:1568781474
Name:THOMAS, SHARRON A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHARRON
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 VETRANS MEMORIAL PARKWAY
Mailing Address - Street 2:SUITE 211
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5033
Mailing Address - Country:US
Mailing Address - Phone:772-335-9808
Mailing Address - Fax:772-335-9818
Practice Address - Street 1:2400 VETRANS MEMORIAL PARKWAY
Practice Address - Street 2:SUITE 211
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5033
Practice Address - Country:US
Practice Address - Phone:772-335-9808
Practice Address - Fax:772-335-9818
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW-30321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical