Provider Demographics
NPI:1225286420
Name:SHELDON, ROSALIND M (CSW, LMHP)
Entity Type:Individual
Prefix:
First Name:ROSALIND
Middle Name:M
Last Name:SHELDON
Suffix:
Gender:F
Credentials:CSW, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 AVENUE A
Mailing Address - Street 2:SUITE E
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-8169
Mailing Address - Country:US
Mailing Address - Phone:308-234-5644
Mailing Address - Fax:308-234-5652
Practice Address - Street 1:3710 CENTRAL AVE STE 9
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-8126
Practice Address - Country:US
Practice Address - Phone:308-251-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3407101YM0800X
NE12871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47080829226Medicaid