Provider Demographics
NPI:1942267562
Name:STOCKS, SHEELA (PHD)
Entity Type:Individual
Prefix:
First Name:SHEELA
Middle Name:
Last Name:STOCKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 COOPER POINT RD SW
Mailing Address - Street 2:BUILDING 17
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-1178
Mailing Address - Country:US
Mailing Address - Phone:360-753-3372
Mailing Address - Fax:360-753-8906
Practice Address - Street 1:1800 COOPER POINT RD SW
Practice Address - Street 2:BUILDING 17
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-1178
Practice Address - Country:US
Practice Address - Phone:360-753-3372
Practice Address - Fax:360-753-8906
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18731103TC0700X
WAPY60221529103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPY60221529OtherWASHINGTON STATE
CAPSY18731OtherLICENSE NUMBER
CA0PL187310Medicare UPIN
CAPSY18731OtherLICENSE NUMBER