Provider Demographics
NPI:1073356184
Name:SHEETS, SIDNEY HAVEN (BSW, MSW, LGSW)
Entity type:Individual
Prefix:MS
First Name:SIDNEY
Middle Name:HAVEN
Last Name:SHEETS
Suffix:
Gender:U
Credentials:BSW, MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 ABOUT TOWN PL
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-5838
Mailing Address - Country:US
Mailing Address - Phone:304-318-7752
Mailing Address - Fax:
Practice Address - Street 1:1101 ABOUT TOWN PL
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-5838
Practice Address - Country:US
Practice Address - Phone:304-318-7752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00946903104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker