Provider Demographics
NPI:1952523748
Name:MABRY, SHEILAH DENISE (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:SHEILAH
Middle Name:DENISE
Last Name:MABRY
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W 96TH ST
Mailing Address - Street 2:SUITE 10C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6469
Mailing Address - Country:US
Mailing Address - Phone:212-662-0665
Mailing Address - Fax:212-662-0665
Practice Address - Street 1:71 W 12TH ST
Practice Address - Street 2:OFFICE #1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8564
Practice Address - Country:US
Practice Address - Phone:646-337-1028
Practice Address - Fax:212-662-0665
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-071529-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical