Provider Demographics
NPI:1831840412
Name:SHEELEY, TA'MARA
Entity type:Individual
Prefix:
First Name:TA'MARA
Middle Name:
Last Name:SHEELEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 HIGHWAY 20
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-9519
Mailing Address - Country:US
Mailing Address - Phone:541-264-5938
Mailing Address - Fax:
Practice Address - Street 1:3060 HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-9519
Practice Address - Country:US
Practice Address - Phone:541-264-5938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health