Provider Demographics
NPI:1255539128
Name:ADDISON, SHEILA M (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:M
Last Name:ADDISON
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16745
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-0745
Mailing Address - Country:US
Mailing Address - Phone:510-599-5467
Mailing Address - Fax:
Practice Address - Street 1:2006 DWIGHT WAY
Practice Address - Street 2:SUITE 304
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-2633
Practice Address - Country:US
Practice Address - Phone:510-599-5467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61067042106H00000X
MA1897-MH-MF106H00000X
CT2765106H00000X
CA49616106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist