Provider Demographics
NPI:1295256832
Name:EVANS, SHEILA (LPCMH)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:GILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 172
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19903-0172
Mailing Address - Country:US
Mailing Address - Phone:302-678-3020
Mailing Address - Fax:
Practice Address - Street 1:103 MONT BLANC BLVD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-7615
Practice Address - Country:US
Practice Address - Phone:302-678-3020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0000814101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty