Individual provider Active NPI

Sharon C Lash, PSY.D.

  • Psychologist
  • Moline, IL
National Provider Identifier
1780695668
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
2100 52ND Ave
Moline, IL 61265-6366
Phone
(309) 797-2900
Fax
(309) 797-2147
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X IL
Psychologist 103T00000X IL Primary

Addresses

Primary practice location

2100 52ND Ave
Moline, IL 61265-6366

Mailing address

2100 52ND Ave
Moline, IL 61265-6366
Phone (309) 797-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101020000116 IL Practitioner - Clinical Psychologist 5092908343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southpark Psychology LTDGroup PAC ID 8527203090, 21 clinicians

Practice addresses (Care Compare)

2100 52ND Ave
Moline, IL 61265-6366
Phone (309) 797-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071-004847ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southpark Psychology LTD Professional CurrentSince Jan 1, 2013 Accepting new patients

Locations

2100 52nd Ave
Moline, IL 61265
Phone (309) 797-2900

1314 10th St
Silvis, IL 61282
Phone (309) 792-6563

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1780695668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 52ND AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656366",
            "telephone_number": "309-797-2900",
            "fax_number": "309-797-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 52ND AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656366",
            "telephone_number": "309-797-2900",
            "fax_number": "309-797-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASH",
        "first_name": "SHARON",
        "middle_name": "C",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.