Provider Demographics
NPI:1508966755
Name:LIGHTBURN, SHEILA JONES (LCSW MSW)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:JONES
Last Name:LIGHTBURN
Suffix:
Gender:F
Credentials:LCSW MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 8TH ST
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24141
Mailing Address - Country:US
Mailing Address - Phone:540-731-0838
Mailing Address - Fax:540-731-3375
Practice Address - Street 1:200 8TH ST
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141
Practice Address - Country:US
Practice Address - Phone:540-731-0838
Practice Address - Fax:540-731-3375
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040010371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
040612OtherANTHEM
11526663OtherCAQH
278969OtherVALUE OPTIONS