Provider Demographics
NPI:1225332257
Name:BLEVINS-CRISLER, SHELIA ANNETTE (LCSW)
Entity Type:Individual
Prefix:
First Name:SHELIA
Middle Name:ANNETTE
Last Name:BLEVINS-CRISLER
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 1:1125 TOMLIN RD
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38068-5745
Mailing Address - Country:US
Mailing Address - Phone:901-634-3374
Mailing Address - Fax:
Practice Address - Street 1:1125 TOMLIN RD
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38068-5745
Practice Address - Country:US
Practice Address - Phone:901-634-3374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical