Active NPI
Micky M Sharma, PSYD
- Clinical Psychologist
- Dayton, OH
National Provider Identifier
1679574586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5626
- Practice address
- 3640 Colonel Glenn Hwy
Fawc
Dayton, OH 45435-0001 - Phone
- (937) 775-3407
- Fax
- (937) 775-3421
- NPI assigned
- Aug 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5626 | OH | Primary |
Addresses
Primary practice location
3640 Colonel Glenn Hwy
Fawc
Dayton, OH 45435-0001
Mailing address
3640 Colonel Glenn Hwy
Fawc
Dayton, OH 45435-0001
Phone (937) 775-3407
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5626 | OH | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1679574586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3640 COLONEL GLENN HWY",
"address_2": "FAWC",
"city": "DAYTON",
"state": "OH",
"postal_code": "454350001",
"telephone_number": "937-775-3407",
"fax_number": "937-775-3421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3640 COLONEL GLENN HWY",
"address_2": "FAWC",
"city": "DAYTON",
"state": "OH",
"postal_code": "454350001",
"telephone_number": "937-775-3407",
"fax_number": "937-775-3421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARMA",
"first_name": "MICKY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "5626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.