Provider Demographics
NPI:1245323237
Name:SHEIKH, AMBREEN JOY (EDD)
Entity type:Individual
Prefix:DR
First Name:AMBREEN
Middle Name:JOY
Last Name:SHEIKH
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 S MAIN ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-5032
Mailing Address - Country:US
Mailing Address - Phone:919-562-1080
Mailing Address - Fax:919-570-3243
Practice Address - Street 1:1906 S MAIN ST
Practice Address - Street 2:SUITE 120
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-5032
Practice Address - Country:US
Practice Address - Phone:919-562-1080
Practice Address - Fax:919-570-3243
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3003103TC1900X
NJ35SI00408900103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000473Medicaid
NC6000473Medicaid