Provider Demographics
NPI:1598572091
Name:SHELDON, SHIRLEY D (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:D
Last Name:SHELDON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 JANICULUM DR
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-2134
Mailing Address - Country:US
Mailing Address - Phone:636-253-2270
Mailing Address - Fax:
Practice Address - Street 1:2008 JANICULUM DR
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-2134
Practice Address - Country:US
Practice Address - Phone:636-253-2270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0023531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical