Provider Demographics
NPI:1205616604
Name:SHEFFIELD, SHANE ANDREW (MSED)
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:ANDREW
Last Name:SHEFFIELD
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 PROFESSIONAL DR STE K
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-6618
Mailing Address - Country:US
Mailing Address - Phone:757-347-2300
Mailing Address - Fax:
Practice Address - Street 1:1158 PROFESSIONAL DR STE K
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-6618
Practice Address - Country:US
Practice Address - Phone:757-347-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704016010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health