Provider Demographics
NPI:1003198094
Name:BRIDGES-WOODS, SHEILA ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:ANN
Last Name:BRIDGES-WOODS
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 1:4720 CENTER BLVD APT 325
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11109-5663
Mailing Address - Country:US
Mailing Address - Phone:860-770-8640
Mailing Address - Fax:860-780-1103
Practice Address - Street 1:4720 CENTER BLVD APT 325
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11109-5663
Practice Address - Country:US
Practice Address - Phone:860-770-8640
Practice Address - Fax:860-780-1103
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0069091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008046009Medicaid