Provider Demographics
NPI:1265837504
Name:SHEFFIELD, KATHLEEN MARIE (MED, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MARIE
Last Name:SHEFFIELD
Suffix:
Gender:F
Credentials:MED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 WARD AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-4846
Mailing Address - Country:US
Mailing Address - Phone:315-317-2537
Mailing Address - Fax:888-975-4401
Practice Address - Street 1:613 WARD AVE
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-4846
Practice Address - Country:US
Practice Address - Phone:315-317-2537
Practice Address - Fax:888-975-4401
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007708101YP2500X
MS2126101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional