Provider Demographics
NPI:1326514977
Name:GOOD, SHEILA ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:ANN
Last Name:GOOD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16071 STATE HIGHWAY 3W
Mailing Address - Street 2:
Mailing Address - City:BYARS
Mailing Address - State:OK
Mailing Address - Zip Code:74831-7367
Mailing Address - Country:US
Mailing Address - Phone:405-862-8939
Mailing Address - Fax:
Practice Address - Street 1:921 NE 13TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5007
Practice Address - Country:US
Practice Address - Phone:405-868-5052
Practice Address - Fax:405-456-1214
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK29022164W00000X
OK61041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty