Provider Demographics
NPI:1417173477
Name:SAMPTON, SHEILA A (MSW, CAPSW, ICS,CSAC)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:A
Last Name:SAMPTON
Suffix:
Gender:F
Credentials:MSW, CAPSW, ICS,CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 W NORTH AVENUE
Mailing Address - Street 2:COUNSELING AND WELLNESS CLINIC
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53205-1254
Mailing Address - Country:US
Mailing Address - Phone:414-906-2700
Mailing Address - Fax:414-963-2691
Practice Address - Street 1:6318 W NORTH AVE UPPR
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213-2013
Practice Address - Country:US
Practice Address - Phone:414-526-0499
Practice Address - Fax:414-963-2691
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI174H00000X
251S00000X, 171M00000X, 261QM0801X, 261QM0855X
WI1086-132101YA0400X
WI1718-1211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174H00000XOther Service ProvidersHealth Educator
No251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1417173477Medicaid