Provider Demographics
NPI:1467789875
Name:SHEALY, CRAIG (PHD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:SHEALY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 TEMPLE AVE STE 222
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-2981
Mailing Address - Country:US
Mailing Address - Phone:540-292-2557
Mailing Address - Fax:540-886-3975
Practice Address - Street 1:1050 TEMPLE AVE STE 222
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2981
Practice Address - Country:US
Practice Address - Phone:540-292-2557
Practice Address - Fax:540-886-3975
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002551103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical