Provider Demographics
NPI:1568839835
Name:ROCKWELL, SHEILA (ACSW)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:ROCKWELL
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17514 FERN WAY
Mailing Address - Street 2:
Mailing Address - City:CLEARLAKE OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95423-9501
Mailing Address - Country:US
Mailing Address - Phone:707-468-7747
Mailing Address - Fax:707-468-7744
Practice Address - Street 1:630 KINGS CT
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5003
Practice Address - Country:US
Practice Address - Phone:707-468-7747
Practice Address - Fax:707-468-7744
Is Sole Proprietor?:No
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33161104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker