Provider Demographics
NPI:1851499289
Name:CONLIN, SHEILA (LP, LMFT)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:
Last Name:CONLIN
Suffix:
Gender:F
Credentials:LP, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 TANGLEWOOD
Mailing Address - Street 2:#1
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-4684
Mailing Address - Country:US
Mailing Address - Phone:651-303-9003
Mailing Address - Fax:651-766-9046
Practice Address - Street 1:521 TANGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-2016
Practice Address - Country:US
Practice Address - Phone:651-303-9003
Practice Address - Fax:651-766-9046
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLMFT647101YM0800X
MNLP1210103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN211993500OtherMEDICAL ASSISTANCE
MN092D8COOtherBLUE CROSS/BLUE SHIELD
MN6254195OtherMEDICA-UBH