Provider Demographics
NPI:1205946332
Name:DERBY MCLEAN, SHEILA (LMHC)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:DERBY MCLEAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4618 TROUT RIVER XING
Mailing Address - Street 2:
Mailing Address - City:ELLENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34222-7286
Mailing Address - Country:US
Mailing Address - Phone:727-612-0844
Mailing Address - Fax:
Practice Address - Street 1:200 S HOOVER BLVD
Practice Address - Street 2:S-170
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3540
Practice Address - Country:US
Practice Address - Phone:727-612-0844
Practice Address - Fax:813-287-1721
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8445101YM0800X
MA4658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health