Provider Demographics
NPI:1518694777
Name:MCDUFFY, SHEILA TANYA (LMSW)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:TANYA
Last Name:MCDUFFY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 BROAD ST APT 1233
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-2078
Mailing Address - Country:US
Mailing Address - Phone:646-544-7414
Mailing Address - Fax:
Practice Address - Street 1:180 BROAD ST APT 1233
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-2078
Practice Address - Country:US
Practice Address - Phone:646-544-7414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-06
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW139130104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker