Provider Demographics
NPI:1689226482
Name:MCCANN, SHEILA KAY (AAC)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:KAY
Last Name:MCCANN
Suffix:
Gender:F
Credentials:AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 39TH AVE SW APT E102
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-5986
Mailing Address - Country:US
Mailing Address - Phone:253-290-3900
Mailing Address - Fax:
Practice Address - Street 1:3285 FERGUSON STREET SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512
Practice Address - Country:US
Practice Address - Phone:360-943-1907
Practice Address - Fax:360-943-1932
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health