Provider Demographics
NPI:1154893592
Name:ASKEW, SHELDA L
Entity type:Individual
Prefix:MS
First Name:SHELDA
Middle Name:L
Last Name:ASKEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5108 TWISTED WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-3268
Mailing Address - Country:US
Mailing Address - Phone:889-925-0098
Mailing Address - Fax:919-800-3034
Practice Address - Street 1:5108 TWISTED WILLOW WAY
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-3268
Practice Address - Country:US
Practice Address - Phone:888-992-5009
Practice Address - Fax:919-800-3034
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC832840001Medicaid