Provider Demographics
NPI:1902557523
Name:SHEA, SOPHIA ISABEL (LCSW-A)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:ISABEL
Last Name:SHEA
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2432 S CHURCH ST.
Mailing Address - Street 2:SUITE B
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215
Mailing Address - Country:US
Mailing Address - Phone:336-494-8856
Mailing Address - Fax:336-281-0101
Practice Address - Street 1:5101 DUNLEA COURT
Practice Address - Street 2:UNIT 104
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405
Practice Address - Country:US
Practice Address - Phone:336-494-8856
Practice Address - Fax:336-281-0101
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP022127101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional