Provider Demographics
NPI:1992244743
Name:GRANT-MILLER, SHEILA D (ASW 115649)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:D
Last Name:GRANT-MILLER
Suffix:
Gender:F
Credentials:ASW 115649
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1393 BAILEY ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5922
Mailing Address - Country:US
Mailing Address - Phone:559-639-2046
Mailing Address - Fax:
Practice Address - Street 1:1393 BAILEY ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5922
Practice Address - Country:US
Practice Address - Phone:559-639-2026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAY4922972101Y00000X
101Y00000X
CAASW115649101YM0800X
CA115649390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health