Provider Demographics
NPI:1063955748
Name:THOMSEN, SHARON (LMFT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:THOMSEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 BOWLING ST SW APT 135
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-4258
Mailing Address - Country:US
Mailing Address - Phone:602-677-7858
Mailing Address - Fax:
Practice Address - Street 1:2955 BOWLING ST SW APT 135
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-4258
Practice Address - Country:US
Practice Address - Phone:602-677-7858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA080610106H00000X
AZ15443106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist