Provider Demographics
NPI:1437257359
Name:CHRISTY, SHEILA BETH (MA)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:BETH
Last Name:CHRISTY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:SHEILA
Other - Middle Name:BETH
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1381 LEISURE WORLD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-3032
Mailing Address - Country:US
Mailing Address - Phone:623-225-9946
Mailing Address - Fax:480-240-9335
Practice Address - Street 1:4111 E VALLEY AUTO DR STE 106
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4607
Practice Address - Country:US
Practice Address - Phone:623-225-9946
Practice Address - Fax:480-240-9335
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2029106H00000X
AZ15148106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN597K6WIOtherBCBS OF MN