Provider Demographics
NPI:1538743125
Name:DAVIS, SHEILAH THOMAS (ADDC)
Entity type:Individual
Prefix:
First Name:SHEILAH
Middle Name:THOMAS
Last Name:DAVIS
Suffix:
Gender:F
Credentials:ADDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16547 E TUFTS AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1643
Mailing Address - Country:US
Mailing Address - Phone:303-304-8121
Mailing Address - Fax:
Practice Address - Street 1:5250 LEETSDALE DR STE 220
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1451
Practice Address - Country:US
Practice Address - Phone:303-629-5293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000011101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)