Provider Demographics
NPI:1912626532
Name:SUTHERLAND, SHEILA RAE (LGSW, LMSW)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:RAE
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:LGSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 SILVER LAKE RD NW
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1786
Mailing Address - Country:US
Mailing Address - Phone:651-628-9566
Mailing Address - Fax:651-628-0411
Practice Address - Street 1:119 FRIBERG AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2306
Practice Address - Country:US
Practice Address - Phone:218-332-2018
Practice Address - Fax:218-332-2019
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN280181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical