Provider Demographics
NPI:1659467207
Name:ASHBY, SHEILA J (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:J
Last Name:ASHBY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4230 LINCOLNSHIRE DRIVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:MT VERNON
Mailing Address - State:IL
Mailing Address - Zip Code:62801
Mailing Address - Country:US
Mailing Address - Phone:618-242-4205
Mailing Address - Fax:618-242-4209
Practice Address - Street 1:4230 LINCOLNSHIRE DR
Practice Address - Street 2:SUITE E
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-2189
Practice Address - Country:US
Practice Address - Phone:618-242-4205
Practice Address - Fax:618-242-4209
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-005816104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker