Provider Demographics
NPI:1114437530
Name:KILLINGSWORTH-THOMAS, SHEILA ELIZABETH (CADC-I)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:ELIZABETH
Last Name:KILLINGSWORTH-THOMAS
Suffix:
Gender:
Credentials:CADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1839 W REDLANDS BLVD BLDG 9
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-3118
Mailing Address - Country:US
Mailing Address - Phone:909-501-5167
Mailing Address - Fax:
Practice Address - Street 1:1889 W REDLANDS BLVD BLDG 9
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-3119
Practice Address - Country:US
Practice Address - Phone:909-501-5167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACICA01400619101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)