Provider Demographics
NPI:1063763001
Name:SHELDON, AMANDA BETH (BS, MA)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:BETH
Last Name:SHELDON
Suffix:
Gender:F
Credentials:BS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E HAWTHORN PKWY
Mailing Address - Street 2:#235
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1463
Mailing Address - Country:US
Mailing Address - Phone:847-737-8787
Mailing Address - Fax:847-859-5885
Practice Address - Street 1:175 E HAWTHORN PKWY
Practice Address - Street 2:#235
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1463
Practice Address - Country:US
Practice Address - Phone:847-737-8787
Practice Address - Fax:847-859-5885
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health