Provider Demographics
NPI:1689740847
Name:SHELDON, KRISTA L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:L
Last Name:SHELDON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:L
Other - Last Name:FANCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:15550 N FRANK LLOYD WRIGHT BLVD UNIT 1056
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2034
Mailing Address - Country:US
Mailing Address - Phone:602-717-1182
Mailing Address - Fax:602-470-5064
Practice Address - Street 1:3141 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4360
Practice Address - Country:US
Practice Address - Phone:602-914-1520
Practice Address - Fax:602-266-0545
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-104621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical