Provider Demographics
NPI:1417435413
Name:WILLIAMS, SHELIA E (LPC, CSAC, LSATP)
Entity Type:Individual
Prefix:
First Name:SHELIA
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC, CSAC, LSATP
Other - Prefix:
Other - First Name:SHELIA
Other - Middle Name:
Other - Last Name:BLOOMFIELD-WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15521 MIDLOTHIAN TPKE STE 105
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-7313
Mailing Address - Country:US
Mailing Address - Phone:804-207-6737
Mailing Address - Fax:
Practice Address - Street 1:15521 MIDLOTHIAN TPKE STE 105
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-7313
Practice Address - Country:US
Practice Address - Phone:804-207-6737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000374101YA0400X
VA0710103092101YA0400X
VA0701007711101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30016107240002Medicaid