Provider Demographics
NPI:1376947291
Name:EBBRECHT, SHEILA (LISW-S)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:EBBRECHT
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:KAY
Other - Last Name:HEINTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:392 INGLEWOOD DR.
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:270 S. HEMPSTEAD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081
Practice Address - Country:US
Practice Address - Phone:614-797-7230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI. 00079531041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool