Provider Demographics
NPI:1598541989
Name:SHEETS, ANDREW WILLIAM (LSW)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:WILLIAM
Last Name:SHEETS
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 OLD HARSHMAN RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1238
Mailing Address - Country:US
Mailing Address - Phone:937-259-6630
Mailing Address - Fax:
Practice Address - Street 1:805 OLD HARSHMAN RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:OH
Practice Address - Zip Code:45431-1238
Practice Address - Country:US
Practice Address - Phone:937-259-6630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.22079031041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool