Provider Demographics
NPI:1942352711
Name:MCBRIDE, SHEILA MARIE (CAC)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:MARIE
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 MISSION DR
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-5561
Mailing Address - Country:US
Mailing Address - Phone:304-485-1781
Mailing Address - Fax:304-485-1782
Practice Address - Street 1:1011 MISSION DR
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-5561
Practice Address - Country:US
Practice Address - Phone:304-485-1781
Practice Address - Fax:304-485-1782
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV04-101101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV04-101OtherCAC