Provider Demographics
NPI:1952427643
Name:AHMADI, SHEILA VALERIA (SOCIAL WORKER)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:VALERIA
Last Name:AHMADI
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:MS
Other - First Name:SHEILA
Other - Middle Name:VALERIA
Other - Last Name:EARLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:14 TOPSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-8360
Mailing Address - Country:US
Mailing Address - Phone:540-255-4452
Mailing Address - Fax:
Practice Address - Street 1:14 TOPSIDE CIR
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-8360
Practice Address - Country:US
Practice Address - Phone:540-255-4452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040061301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1639218373Medicare UPIN