Healthcare Provider Details

I. General information

NPI: 1326110586
Provider Name (Legal Business Name): SHARON SMITH THOMPSON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. SHARON PATRICIA SMITH

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 S AUBURNDALE ST
MEMPHIS TN
38104-3916
US

IV. Provider business mailing address

760 N AUBURNDALE ST
MEMPHIS TN
38107-4530
US

V. Phone/Fax

Practice location:
  • Phone: 901-729-3900
  • Fax: 901-729-2737
Mailing address:
  • Phone: 901-679-5344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2743
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number2743
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: