Constance B. Sharp, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY60043856 Issued in WA

Practice address

12430 Lakeland Ave SW
Lakewood, WA 98498

Phone

(253) 279-5876

NPI assigned

May 16, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Connie Sharp Professional name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1245497411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12430 LAKELAND AVE SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98498",
            "telephone_number": "253-279-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12430 LAKELAND AVE SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98498",
            "telephone_number": "253-279-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "CONSTANCE",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60043856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "SHARP",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Justin Shannon
• Justin Shannon
• Salisa Shannon, LMT
• Mardelyn Sharifi
• Kailash Nath Sharma, RN
• Ryan Lee Balag Sharpe, NURSING ASSISTANT
• Stephanie Sharrah
• Shannon May Shattuck, BA
• Anthony Shaw
• Hope Shaw

• Psychologist in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.