Provider Demographics
NPI:1083967004
Name:SHEFFLER, KRISTILEE P (LGSW)
Entity Type:Individual
Prefix:
First Name:KRISTILEE
Middle Name:P
Last Name:SHEFFLER
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 LANDMARK DR
Mailing Address - Street 2:SUITE 118
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4486
Mailing Address - Country:US
Mailing Address - Phone:410-863-7213
Mailing Address - Fax:410-863-7205
Practice Address - Street 1:804 LANDMARK DR
Practice Address - Street 2:SUITE 118
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4486
Practice Address - Country:US
Practice Address - Phone:410-863-7213
Practice Address - Fax:410-863-7205
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD184811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical