Provider Demographics
NPI:1780834804
Name:MILLAN, SHEILA KAY (LCSW)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:KAY
Last Name:MILLAN
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 1:1038 CORTEZ RD
Mailing Address - Street 2:
Mailing Address - City:BRYCEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32009-1310
Mailing Address - Country:US
Mailing Address - Phone:904-534-1714
Mailing Address - Fax:
Practice Address - Street 1:1601 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1135
Practice Address - Country:US
Practice Address - Phone:904-534-1714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW61241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical