Provider Demographics
NPI:1134284995
Name:FELLOWS, SHEILA ANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:ANNE
Last Name:FELLOWS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 370995
Mailing Address - Street 2:
Mailing Address - City:MONTARA
Mailing Address - State:CA
Mailing Address - Zip Code:94037-0995
Mailing Address - Country:US
Mailing Address - Phone:650-728-5418
Mailing Address - Fax:650-728-5418
Practice Address - Street 1:131 KELLY AVE
Practice Address - Street 2:
Practice Address - City:HALF MOON BAY
Practice Address - State:CA
Practice Address - Zip Code:94019-1629
Practice Address - Country:US
Practice Address - Phone:650-728-5418
Practice Address - Fax:650-728-5418
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 17353101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health