Provider Demographics
NPI:1134315195
Name:PARKINSON, SHARON MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:MARIE
Last Name:PARKINSON
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:MARIE
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1044 S LAKE DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-6113
Mailing Address - Country:US
Mailing Address - Phone:239-370-1188
Mailing Address - Fax:855-816-3442
Practice Address - Street 1:2590 GOLDEN GATE PKWY STE 108
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-3204
Practice Address - Country:US
Practice Address - Phone:239-370-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7793103G00000X, 103TC0700X
PAPS016442103TC0700X
NC3447103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA126191OtherMEDICARE PTAN
PA126191OtherMEDICARE PTAN
NC2823654Medicare UPIN