Provider Demographics
NPI:1790417046
Name:SHARPES, JONATHAN DAVID
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:DAVID
Last Name:SHARPES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 DONELSONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-2909
Mailing Address - Country:US
Mailing Address - Phone:615-712-5911
Mailing Address - Fax:
Practice Address - Street 1:5409 MARYLAND WAY
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5037
Practice Address - Country:US
Practice Address - Phone:615-373-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1444101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health