Provider Demographics
NPI:1144696022
Name:GINGERICH, SHEILA D
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:D
Last Name:GINGERICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 RINGLING BLVD
Mailing Address - Street 2:SUITE F-123
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5334
Mailing Address - Country:US
Mailing Address - Phone:941-376-6440
Mailing Address - Fax:
Practice Address - Street 1:2831 RINGLING BLVD
Practice Address - Street 2:SUITE F-123
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5334
Practice Address - Country:US
Practice Address - Phone:941-376-6440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW128721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical