Provider Demographics
NPI:1760640023
Name:HEAD, SHELIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHELIA
Middle Name:
Last Name:HEAD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1895 PHOENIX BLVD
Mailing Address - Street 2:166
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-5592
Mailing Address - Country:US
Mailing Address - Phone:404-271-8443
Mailing Address - Fax:404-344-7480
Practice Address - Street 1:1895 PHOENIX BLVD
Practice Address - Street 2:166
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-5592
Practice Address - Country:US
Practice Address - Phone:404-271-8443
Practice Address - Fax:404-344-7480
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0004911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical