Provider Demographics
NPI:1609911882
Name:FUNK-JANSEN, SHEILA A (LISW, LCSW)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:A
Last Name:FUNK-JANSEN
Suffix:
Gender:F
Credentials:LISW, LCSW
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:A
Other - Last Name:GARMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1536 W CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-1741
Mailing Address - Country:US
Mailing Address - Phone:660-216-1580
Mailing Address - Fax:
Practice Address - Street 1:2435 KIMBERLY RD STE 10N
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3572
Practice Address - Country:US
Practice Address - Phone:660-216-1580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490148201041C0700X
MO20210255951041C0700X
IA0078361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical