Provider Demographics
NPI:1427201193
Name:MCGIBBON, SHEILA (LCSW)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:MCGIBBON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 PENNSYLVANIA AVE
Mailing Address - Street 2:APT 709
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806
Mailing Address - Country:US
Mailing Address - Phone:302-652-7961
Mailing Address - Fax:
Practice Address - Street 1:1401 PENNSYLVANIA AVE
Practice Address - Street 2:APT 709
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-4124
Practice Address - Country:US
Practice Address - Phone:302-652-7961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00009181041C0700X
FLSW81781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical