Provider Demographics
NPI:1073520433
Name:SHEEAN, CAROL A (MSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
Last Name:SHEEAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 S 19TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1918
Mailing Address - Country:US
Mailing Address - Phone:253-752-6056
Mailing Address - Fax:253-759-7129
Practice Address - Street 1:3609 S 19TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1918
Practice Address - Country:US
Practice Address - Phone:253-752-6056
Practice Address - Fax:253-759-7129
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000049641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical