Provider Demographics
NPI:1750788352
Name:JOHNSON, SHARON
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 SUMMAR DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-3906
Mailing Address - Country:US
Mailing Address - Phone:731-541-8200
Mailing Address - Fax:731-660-8739
Practice Address - Street 1:1804 HIGHWAY 45 BYP
Practice Address - Street 2:SUITE 604
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-4436
Practice Address - Country:US
Practice Address - Phone:731-512-1273
Practice Address - Fax:731-660-8739
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health