Basic Information
| Provider Information | |||||||||
| NPI: | 1568781474 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | SHARRON | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 VETRANS MEMORIAL PARKWAY | ||||||||
| Address2: | SUITE 211 | ||||||||
| City: | PORT ST LUCIE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349525033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7723359808 | ||||||||
| FaxNumber: | 7723359818 | ||||||||
| Practice Location | |||||||||
| Address1: | 2400 VETRANS MEMORIAL PARKWAY | ||||||||
| Address2: | SUITE 211 | ||||||||
| City: | PORT ST LUCIE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349525033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7723359808 | ||||||||
| FaxNumber: | 7723359818 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2010 | ||||||||
| LastUpdateDate: | 07/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | SW-3032 | FL | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.