Provider Demographics
NPI:1275070153
Name:KIRKBRIDE, SHELIA LYNNE (MS)
Entity Type:Individual
Prefix:
First Name:SHELIA
Middle Name:LYNNE
Last Name:KIRKBRIDE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CHADWICK DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-4622
Mailing Address - Country:US
Mailing Address - Phone:703-568-2893
Mailing Address - Fax:
Practice Address - Street 1:9 CHADWICK DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-4622
Practice Address - Country:US
Practice Address - Phone:703-568-2893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health