Provider Demographics
NPI:1598421752
Name:SHEAK, ASHLEIGH (MS)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:SHEAK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 COLLEEN AVE
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-6201
Mailing Address - Country:US
Mailing Address - Phone:651-900-3815
Mailing Address - Fax:
Practice Address - Street 1:190 COLLEEN AVE
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-6201
Practice Address - Country:US
Practice Address - Phone:651-900-3815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health