Provider Demographics
NPI:1750004180
Name:BAEZ, SHEILA (LPC-R)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:BAEZ
Suffix:
Gender:F
Credentials:LPC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 GRANBY ST STE 105
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-2531
Mailing Address - Country:US
Mailing Address - Phone:315-771-4211
Mailing Address - Fax:
Practice Address - Street 1:215 YORKTOWN DR APT B
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:VA
Practice Address - Zip Code:23801-1332
Practice Address - Country:US
Practice Address - Phone:315-771-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014858101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health