Provider Demographics
NPI:1649312869
Name:MADDEN, SHEILA ANNE (LMFT)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:ANNE
Last Name:MADDEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:ANNE
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2131 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703
Mailing Address - Country:US
Mailing Address - Phone:510-644-1796
Mailing Address - Fax:
Practice Address - Street 1:902 CARMEL AVE
Practice Address - Street 2:#5
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706
Practice Address - Country:US
Practice Address - Phone:510-644-1796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37464101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8166Medicaid
CA8166OtherCALIFORNIA MEDICAL