Provider Demographics
NPI:1528186335
Name:LENTZ, SHARON (MA, PSYD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:LENTZ
Suffix:
Gender:F
Credentials:MA, PSYD
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:VON LENTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,PSYD
Mailing Address - Street 1:8231 N 21ST DR
Mailing Address - Street 2:#E101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4946
Mailing Address - Country:US
Mailing Address - Phone:602-334-3776
Mailing Address - Fax:623-889-0972
Practice Address - Street 1:15282 W BROOKSIDE LN
Practice Address - Street 2:SUITE #110-A
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2447
Practice Address - Country:US
Practice Address - Phone:623-889-7458
Practice Address - Fax:623-889-0972
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2044103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical